Provider Demographics
NPI:1487834305
Name:SCHILLINGER, AMIE MICHELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:MICHELLE
Last Name:SCHILLINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:AMIE
Other - Middle Name:MICHELLE
Other - Last Name:MALKUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2740 SOUTH AVENUE WEST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-5137
Mailing Address - Country:US
Mailing Address - Phone:406-728-6101
Mailing Address - Fax:406-721-3278
Practice Address - Street 1:2740 SOUTH AVENUE WEST
Practice Address - Street 2:SUITE 101
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-5137
Practice Address - Country:US
Practice Address - Phone:406-728-6101
Practice Address - Fax:406-721-3278
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT67546363A00000X
NDPAC0378363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011002124Medicare PIN
MTM011000150Medicare PIN
MTM011000149Medicare PIN