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Individual

JASON SCOTT SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
503 DEPOT ROAD, PAINTSVILLE, KY 41240
(606) 793-5077
Mailing address
503 DEPOT ROAD, PAINTSVILLE, KY 41240
(606) 793-5077

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010744
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100442040
KY
Enumeration date
11/12/2016
Last updated
03/27/2024
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