Provider Demographics
NPI:1659344935
Name:SCHILLING, PHYLLIS (RN, CDE)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:SCHILLING
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 277045
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7045
Mailing Address - Country:US
Mailing Address - Phone:240-379-6045
Mailing Address - Fax:240-379-6050
Practice Address - Street 1:5500 BUCKEYSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8331
Practice Address - Country:US
Practice Address - Phone:240-379-6045
Practice Address - Fax:240-379-6050
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR121647163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0992-0628OtherCERTIFIED DIABETES ED.