Provider Demographics
NPI:1508299751
Name:SCHEID, ANGELA D (PNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:SCHEID
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11055 TWIN CREEKS CV
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-2204
Practice Address - Country:US
Practice Address - Phone:260-425-6120
Practice Address - Fax:260-425-6115
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004617A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28163105AOtherRN LICENSE
IN71004617BOtherCSR
IN71004617AOtherPNP LICENSE