Provider Demographics
NPI:1861705543
Name:SCHEUERMAN, CHARLIE RENTH (RN)
Entity type:Individual
Prefix:MR
First Name:CHARLIE
Middle Name:RENTH
Last Name:SCHEUERMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:REN
Other - Middle Name:
Other - Last Name:SCHEUERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:25101 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5643
Mailing Address - Country:US
Mailing Address - Phone:216-831-6611
Mailing Address - Fax:216-456-8128
Practice Address - Street 1:10200 FOREST GREEN BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5165
Practice Address - Country:US
Practice Address - Phone:502-552-5068
Practice Address - Fax:502-515-3666
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1109206163W00000X
KY3006884363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3006884OtherLICENSE
KY3006884OtherLICENSE