Provider Demographics
NPI:1194704114
Name:SCHILLING, DEBORAH A (PAC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:SCHILLING
Suffix:
Gender:F
Credentials:PAC
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 8674
Mailing Address - Street 2:1230 E MAIN ST
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1575 LOOKOUT DR
Practice Address - Street 2:MANKATO CLINIC AT NORTH MANKATO
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003
Practice Address - Country:US
Practice Address - Phone:507-625-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9269363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP40621OtherHEALTH PARTNERS
MN0110220OtherMEDICA
MN117134OtherUCARE
MN06Q82SCOtherBCBS
IA0966523Medicaid
080125802OtherRR MEDICARE
MN1752925OtherAMERICAS PPO
41084933956001C122OtherCHAMPUS
MN538533400Medicaid
MNNA2951020428OtherPREFERRED ONE
MN0110220OtherMEDICA
MN538533400Medicaid