Individual
MS. JEANNE S SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1413 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3407
(636) 332-5400
(636) 332-5404
Mailing address
1413 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3407
(636) 332-5400
(636) 332-5404
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
073396
MO
Other
Enumeration date
07/18/2006
Last updated
02/28/2013
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