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NPI Code Detail

MEDICARE: MR. CHARLIE RENTH SCHEUERMAN RN

MEDICARE: MR. CHARLIE RENTH SCHEUERMAN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse1109206KY
2363LP0808XPsychiatric/Mental Health Nurse Practitioner3006884KY
3363LF0000XFamily Nurse Practitioner3006884KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13006884OTHERKYLICENSE

General Provider Information

NPI Number : 1861705543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLIE RENTH SCHEUERMAN RN
Provider Business Mailing Address
First Line : 10260 SW GREENBURG RD FL 4
Second Line :
City : PORTLAND
State : OR
Zip : 97223-5500
Country : US
Telephone Number : 503-436-5925
Fax Number : 503-470-1865
Provider Business Practice Location Address
First Line : 10260 SW GREENBURG RD FL 4
Second Line :
City : PORTLAND
State : OR
Zip : 97223-5500
Country : US
Telephone Number : 503-436-5925
Fax Number : 503-470-1865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2010
Last Update Date : 04/07/2026

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