Individual
MS. DAWN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
417 W MAIN ST, WISE, VA 24293-6904
(276) 328-7071
(276) 328-6082
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024164454
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010044758
—
VA
05
—
78004942
—
KY
Enumeration date
06/02/2006
Last updated
07/27/2012
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