Individual
JILL VAN EARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3413 HARVEST DR, GORDONVILLE, PA 17529-9586
(717) 768-7141
(717) 768-3528
Mailing address
4131 OREGON PIKE, SUITE C, EPHRATA, PA 17522-9550
(717) 859-5161
(717) 859-5169
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP010061
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101205598 0001
—
PA
01
—
3647470
AETNAHMO
PA
01
—
50038208
ID/CAPITOLBLUECROSS
PA
01
—
50038209
GRP#/CAPBLUECROSS
PA
01
—
7233600
AETNAPPO/PIN
PA
01
—
EA1641588
HIGHMARK BLUE SHEILD
PA
Enumeration date
05/24/2005
Last updated
05/27/2015
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