Individual
STEPHANIE ANN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1907 E PITTSBURG CHURCH RD, LONDON, KY 40741-9047
(606) 389-5269
(606) 389-5276
Mailing address
1907 E PITTSBURG CHURCH RD, LONDON, KY 40741-9047
(606) 389-5269
(606) 389-5276
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
1128589
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3012415
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100549240
—
KY
Enumeration date
12/04/2014
Last updated
03/08/2024
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