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Individual

AMY NICOLE SHORTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP-AG

Contact information

Practice address
271 MEDICAL PARK BLVD, BRISTOL, TN 37620-7455
(423) 274-8600
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
(423) 282-1657

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2021040583
MO
363LC1500X
Community Health Nurse Practitioner
0024190101
VA
363LG0600X
Gerontology Nurse Practitioner
Primary
0024190101
VA
363LG0600X
Gerontology Nurse Practitioner
36565
TN

Other

Enumeration date
11/12/2021
Last updated
08/05/2025
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