Provider Demographics
NPI:1619585171
Name:PAJIBO, NYLEEN VALENTINA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:NYLEEN
Middle Name:VALENTINA
Last Name:PAJIBO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHEYNEY RD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1805
Mailing Address - Country:US
Mailing Address - Phone:610-361-3200
Mailing Address - Fax:
Practice Address - Street 1:500 CHEYNEY RD
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1805
Practice Address - Country:US
Practice Address - Phone:610-361-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily