Basic Information
Provider Information
NPI: 1962935536
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHEIDING
FirstName: ROBERT
MiddleName: RUSSELL
NamePrefix: MR.
NameSuffix: II
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 212 E MAIN ST
Address2:  
City: GREENVILLE
State: OH
PostalCode: 453311913
CountryCode: US
TelephoneNumber: 9375481635
FaxNumber: 9375481500
Practice Location
Address1: 212 E MAIN ST
Address2:  
City: GREENVILLE
State: OH
PostalCode: 453311913
CountryCode: US
TelephoneNumber: 9375481635
FaxNumber: 9375481500
Other Information
ProviderEnumerationDate: 04/10/2017
LastUpdateDate: 04/10/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XPN141399OHY Nursing Service ProvidersLicensed Practical Nurse 
164W00000X27065762AINN Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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