Individual
CHRISTY D. SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
(262) 245-2248
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036138762
IL
207P00000X
Emergency Medicine Physician
Primary
60834-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659699833
BCBSWI
WI
05
—
1659699833
—
WI
05
—
388608210 1
—
IL
01
—
SHORTCHR
MERCYCARE INSURANCE
WI
Enumeration date
05/12/2010
Last updated
07/23/2020
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