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Individual

KERRY SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9200 W WISCONSIN AVE, TRAUMA SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-8623
(414) 805-8641
Mailing address
9200 W WISCONSIN AVE, TRAUMA SURGERY, MILWAUKEE, WI 53226-3522
(414) 805-8623
(414) 805-8641

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
121125
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
121125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100014570
WI
Enumeration date
08/20/2010
Last updated
11/22/2021
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