Provider Demographics
NPI:1720036544
Name:SCHILLING, KATHLEEN A (APN, C)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:SCHILLING
Suffix:
Gender:F
Credentials:APN, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21138 W VIEW
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-1785
Mailing Address - Country:US
Mailing Address - Phone:973-903-3251
Mailing Address - Fax:973-537-5995
Practice Address - Street 1:21138 W VIEW
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:NJ
Practice Address - Zip Code:07885-1785
Practice Address - Country:US
Practice Address - Phone:973-903-3251
Practice Address - Fax:973-537-5995
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC06191000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8297908Medicaid
P07584Medicare UPIN
NJ038239Medicare ID - Type Unspecified