Provider Demographics
NPI:1245533769
Name:SCHILLING, CHRISTIAN MANFRED (LPN)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:MANFRED
Last Name:SCHILLING
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 108TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7110
Mailing Address - Country:US
Mailing Address - Phone:941-545-6270
Mailing Address - Fax:
Practice Address - Street 1:313 108TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7110
Practice Address - Country:US
Practice Address - Phone:941-545-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1165301164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683051079Medicaid