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Individual

TODD ROBERT SHORTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
6153 W OLIVE AVE, GLENDALE, AZ 85302-4564
(602) 685-6000
(623) 937-2589
Mailing address
3003 N CENTRAL AVE STE 200, PHOENIX, AZ 85012-2914
(602) 685-6000

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP10286
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277858
AZ
Enumeration date
02/24/2016
Last updated
07/21/2022
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