Provider Demographics
NPI:1396141966
Name:SCHILLER, BETH (AGNP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:NY
Mailing Address - Zip Code:12936-2533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:S BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6749
Practice Address - Country:US
Practice Address - Phone:802-448-9370
Practice Address - Fax:802-448-1414
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0109026363LA2200X
VT026.0089659163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY665408OtherRN LICENSE
VT101.0109026OtherAGNP LICENSE