Individual
MRS. AMANDA LEA NICHOLE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
6391 STUDEBAKER RD, TIPP CITY, OH 45371-9313
(937) 506-8776
Mailing address
6391 STUDEBAKER RD, TIPP CITY, OH 45371-9313
(937) 506-8776
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
366720
OH
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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