Provider Demographics
NPI:1891723854
Name:SCHILLING, SAMUEL SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:SCOTT
Last Name:SCHILLING
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-3688
Mailing Address - Country:US
Mailing Address - Phone:985-839-4431
Mailing Address - Fax:985-795-0876
Practice Address - Street 1:1900 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-3688
Practice Address - Country:US
Practice Address - Phone:985-839-4431
Practice Address - Fax:985-795-0876
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR873073367500000X
LARN100264367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered