Individual
KIMBERLY SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
806 ELLIS AVE, NEWTOWN SQUARE, PA 19073-3906
(610) 772-1911
Mailing address
806 ELLIS AVE, NEWTOWN SQUARE, PA 19073-3906
(610) 772-1911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN529138L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP023469
BOARD OF NURSING
PA
Enumeration date
01/06/2021
Last updated
03/15/2021
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