Provider Demographics
NPI:1205419249
Name:SCHEIBL, LODUSKA (NP)
Entity Type:Individual
Prefix:
First Name:LODUSKA
Middle Name:
Last Name:SCHEIBL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 DETROIT HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON ISLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54246-9177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2901 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1851
Practice Address - Country:US
Practice Address - Phone:360-734-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202009854NP-PP363L00000X
WI10505-33363L00000X
WAAP61109680363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner