| NPI | 1407824196 |
|---|---|
| Former Name | JENNIFER ANN SHORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-45150) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45150) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MO 2021013215) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2022-12-12 |