Individual
BLAIR P SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10810 PARKSIDE DR, SUITE G11, KNOXVILLE, TN 37934-1979
(865) 218-6660
(865) 218-6661
Mailing address
PO BOX 23740, KNOXVILLE, TN 37933-1740
(865) 549-4342
(865) 549-4341
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN0000110899
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3704598
—
TN
Enumeration date
04/15/2008
Last updated
04/15/2008
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