Provider Demographics
NPI:1376330829
Name:HERD, SHELLI RENEE
Entity type:Individual
Prefix:
First Name:SHELLI
Middle Name:RENEE
Last Name:HERD
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 1:5812 SHILOH BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73179-7900
Mailing Address - Country:US
Mailing Address - Phone:405-274-9364
Mailing Address - Fax:
Practice Address - Street 1:5812 SHILOH BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73179-7900
Practice Address - Country:US
Practice Address - Phone:405-274-9364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider