Individual
JENNIFER MARIE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
13845 CONLAN CIR, CHARLOTTE, NC 28277-2705
(704) 544-2092
Mailing address
13845 CONLAN CIRCLE, CHARLOTTE, NC 28277-0060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001002003
NC
363AM0700X
Medical Physician Assistant
0010-02003
NC
Other
Enumeration date
10/23/2009
Last updated
10/02/2017
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