Provider Demographics
NPI:1053069948
Name:HERINK, SHELLINA MARIE
Entity type:Individual
Prefix:
First Name:SHELLINA
Middle Name:MARIE
Last Name:HERINK
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 1:606 3RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:TRAER
Mailing Address - State:IA
Mailing Address - Zip Code:50675-1240
Mailing Address - Country:US
Mailing Address - Phone:319-478-4242
Mailing Address - Fax:
Practice Address - Street 1:606 3RD ST STE B
Practice Address - Street 2:
Practice Address - City:TRAER
Practice Address - State:IA
Practice Address - Zip Code:50675-1240
Practice Address - Country:US
Practice Address - Phone:319-478-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist