Individual
AIREUS L SHERROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
494 W 23RD AVE, GARY, IN 46407-3017
(219) 246-3406
Mailing address
805 W MARION ST, ELKHART, IN 46516-2640
(574) 206-5265
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1119
—
IN
Enumeration date
12/12/2020
Last updated
01/03/2021
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