Individual
CASEY JOSEPH SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2700
Mailing address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2700
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
64300
ID
363LF0000X
Family Nurse Practitioner
Primary
8671393
ID
Other
Enumeration date
11/24/2025
Last updated
02/05/2026
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