Provider Demographics
NPI:1669931747
Name:SCHEIDT, RADGELINE GRACE (LPN)
Entity type:Individual
Prefix:MRS
First Name:RADGELINE
Middle Name:GRACE
Last Name:SCHEIDT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WAGER PL
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-1865
Mailing Address - Country:US
Mailing Address - Phone:616-527-9392
Mailing Address - Fax:
Practice Address - Street 1:3 WAGER PL
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-1865
Practice Address - Country:US
Practice Address - Phone:616-527-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703108401164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse