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NPI Code Detail

MEDICARE: JESSICA RENEE SHORT

MEDICARE: JESSICA RENEE SHORT
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
1163WS0200XSchool Registered Nurse338280OH

General Provider Information

NPI Number : 1265378392
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA RENEE SHORT
Provider Business Mailing Address
First Line : 401 CLARA DR
Second Line :
City : TRENTON
State : OH
Zip : 45067-1109
Country : US
Telephone Number : 513-594-3055
Fax Number :
Provider Business Practice Location Address
First Line : 4641 BACH LN
Second Line :
City : FAIRFIELD
State : OH
Zip : 45014-1900
Country : US
Telephone Number : 513-829-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2026
Last Update Date : 04/29/2026

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Directions to “ JESSICA RENEE SHORT ” Practice Location

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