Provider Demographics
NPI:1689397754
Name:LAIBINIS, JILL CHRISTINE (PMHNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:CHRISTINE
Last Name:LAIBINIS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 S LEHIGH ST
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1605
Mailing Address - Country:US
Mailing Address - Phone:570-371-8151
Mailing Address - Fax:
Practice Address - Street 1:8 S LEHIGH ST
Practice Address - Street 2:
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-1605
Practice Address - Country:US
Practice Address - Phone:570-371-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026296363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health