Individual
KIRSTEN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1218 E 9TH ST, SUITE 1, EDMOND, OK 73034-5952
(405) 896-6777
(405) 896-6825
Mailing address
1218 E 9TH ST, SUITE 1, EDMOND, OK 73034-5952
(405) 896-6777
(405) 896-6825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2453
OK
Other
Enumeration date
01/14/2015
Last updated
10/30/2020
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