Provider Demographics
NPI:1932394152
Name:SCHOLL, LOREN P (APNP)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:P
Last Name:SCHOLL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:
Practice Address - Street 1:311 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-2401
Practice Address - Country:US
Practice Address - Phone:920-743-0255
Practice Address - Fax:920-743-6680
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3185-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36050500Medicaid
WI3185-33OtherWISCONSIN LICENSE
WIP00645408Medicare Oscar/Certification
WI071700045Medicare Oscar/Certification
WI006307510Medicare Oscar/Certification
WI3185-33OtherWISCONSIN LICENSE
WI590050031Medicare Oscar/Certification
WIK400142823Medicare Oscar/Certification
WIWI1097010Medicare Oscar/Certification
WI36050500Medicaid
WI059005Medicare Oscar/Certification