Doctor Name: | DEBRA ANN SHORT |
NPI Number: | 1154623734 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP60192028 |
Business Practice Address: | 181 W. Jewett Blvd White Salmon, WA - 98672 |
Business Phone Number: | 5094931470 |
Business Fax Number: | |
Mailing Address: | Po Box 2319, WHITE SALMON |
State: | WA |
Postal Code: | 986722319 |
Phone Number: | 5094931470 |
Fax Number: | |
NPI Enumeration Date: | 12/02/2010 |
NPI Last Update Date: | 10/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP60192028 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |