Pay Your PH Community Nurses Bill Online

Back to PH Community Nurses

Please use the form below to make a payment to Penn Highlands Community Nurses.

We accept MasterCard, Visa and Discover.

Statement of Account Information

Patient First Name:
Patient Last Name:
Patient ID:
(beginning with HH, HO or SS)
Invoice Period:
to
Payment Amount: $
(Amount you are going to pay)

Billing Information

First Name:
Last Name:
Email:
Address:
Address Line 2:
City:
State:
Zip:
Phone:

Credit Card Information

Type of Credit Card:
Name on Card:
Card Number:
(Numbers only, no spaces or dashes)
Expiration Date:
CVV Number:
What is a CVV number?

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