Provider Demographics
NPI:1730948761
Name:SCHEELER, RILEY CAITLIN
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:CAITLIN
Last Name:SCHEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 FORELAND GARTH
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-3088
Mailing Address - Country:US
Mailing Address - Phone:443-987-8904
Mailing Address - Fax:
Practice Address - Street 1:650 MCHENRY RD STE 3200
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2681
Practice Address - Country:US
Practice Address - Phone:443-843-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR228057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily