Individual
LISA SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2070 NORTHBROOK BLVD STE A20, N CHARLESTON, SC 29406-9324
(843) 953-0038
Mailing address
2070 NORTHBROOK BLVD STE A20, N CHARLESTON, SC 29406-9324
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
37582
SC
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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