Provider Demographics
NPI:1639740046
Name:SCHILLER, AMBER LYNN
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9184 WASHINGTON NEW MARTIN RD SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-9398
Mailing Address - Country:US
Mailing Address - Phone:740-572-6740
Mailing Address - Fax:
Practice Address - Street 1:9184 WASHINGTON NEW MARTIN RD SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-9398
Practice Address - Country:US
Practice Address - Phone:740-572-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program