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NPI Code Detail

MEDICARE: MRS. SUSAN MICHELLE SHORT FNPC

MEDICARE: MRS. SUSAN MICHELLE SHORT FNPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner2025049885MO
2363LF0000XFamily Nurse Practitioner0040582OH
3363LF0000XFamily Nurse Practitioner628756TX
4363LF0000XFamily Nurse PractitionerAP115646TX
5363LF0000XFamily Nurse Practitioner4704434851MI

General Provider Information

NPI Number : 1245540137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN MICHELLE SHORT FNPC
Provider Business Mailing Address
First Line : 440 N BARRANCA AVE # 1801
Second Line :
City : COVINA
State : CA
Zip : 91723-1722
Country : US
Telephone Number : 800-924-7811
Fax Number : 877-349-1868
Provider Business Practice Location Address
First Line : 7008 SALEM AVE STE 117
Second Line :
City : LUBBOCK
State : TX
Zip : 79424-2226
Country : US
Telephone Number : 800-924-7811
Fax Number : 877-349-1868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2010
Last Update Date : 12/15/2025

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Directions to “ MRS. SUSAN MICHELLE SHORT FNPC” Practice Location

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