Healthcare Provider Details

I. General information

NPI: 1659668614
Provider Name (Legal Business Name): JESSICA LAYNE SCHILLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 38TH ST STE 300
AUSTIN TX
78705
US

IV. Provider business mailing address

7718 WOOD HOLLOW DR STE 103
AUSTIN TX
78731-1601
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-5721
  • Fax:
Mailing address:
  • Phone: 512-279-6749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number701669
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: