Provider Demographics
NPI:1275096828
Name:HENNING, SHERI SHONELL (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:SHONELL
Last Name:HENNING
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 RIVER WAY APT C
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1724
Mailing Address - Country:US
Mailing Address - Phone:901-649-6347
Mailing Address - Fax:
Practice Address - Street 1:1131 W 6TH ST STE 229
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-1121
Practice Address - Country:US
Practice Address - Phone:714-735-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health