Provider Demographics
NPI:1689819591
Name:RORICK, SHERMAN GALE I (RN)
Entity Type:Individual
Prefix:MR
First Name:SHERMAN
Middle Name:GALE
Last Name:RORICK
Suffix:I
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:SHERMAN
Other - Middle Name:GALE
Other - Last Name:RORICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:13906 PARENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:IN
Mailing Address - Zip Code:46774-9716
Mailing Address - Country:US
Mailing Address - Phone:260-493-2752
Mailing Address - Fax:
Practice Address - Street 1:7950 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4140
Practice Address - Country:US
Practice Address - Phone:260-435-7281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28155468A163W00000X, 163WM0705X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access