Provider Demographics
NPI:1053480913
Name:SCHEIDLE, CHARLA R (APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHARLA
Middle Name:R
Last Name:SCHEIDLE
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 TURKEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-5452
Mailing Address - Country:US
Mailing Address - Phone:410-287-5263
Mailing Address - Fax:410-287-4744
Practice Address - Street 1:1930 TURKEY POINT RD
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:MD
Practice Address - Zip Code:21901-5452
Practice Address - Country:US
Practice Address - Phone:410-287-5263
Practice Address - Fax:410-287-4744
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070399163WP0809X
MD25368201364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402020100Medicaid
MD402020100Medicaid