Provider Demographics
NPI:1659690188
Name:HERROD, SHEENA ROCHA
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:ROCHA
Last Name:HERROD
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 1:5535 GARFIELD STREET
Mailing Address - Street 2:APT 2B
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-980-8888
Mailing Address - Fax:219-980-8888
Practice Address - Street 1:5535 GARFIELD ST
Practice Address - Street 2:APT 2B
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-1893
Practice Address - Country:US
Practice Address - Phone:219-980-8888
Practice Address - Fax:219-980-8888
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN100403-01251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health