Provider Demographics
NPI:1760082002
Name:SCHEIDLER, NICOLE A (NP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:SCHEIDLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:A
Other - Last Name:DOUCETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:420 W 4TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-1948
Mailing Address - Country:US
Mailing Address - Phone:574-307-7673
Mailing Address - Fax:574-307-7688
Practice Address - Street 1:420 W 4TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-1948
Practice Address - Country:US
Practice Address - Phone:574-307-7673
Practice Address - Fax:574-307-7688
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28225566A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily