Provider Demographics
NPI:1306867239
Name:SCHILLER, ADELE LOUISE (CRNP)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:LOUISE
Last Name:SCHILLER
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 1:3601 GRAMERCY WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6741
Mailing Address - Country:US
Mailing Address - Phone:856-273-1713
Mailing Address - Fax:
Practice Address - Street 1:1300 HORIZON DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3970
Practice Address - Country:US
Practice Address - Phone:215-712-2545
Practice Address - Fax:215-712-2540
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP004611H363LG0600X
NJ26NN06956700363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018486480003Medicaid
PA019475Medicare ID - Type Unspecified
PA0018486480003Medicaid