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General NPI Number Information
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NPI Number | 1033428735
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Entity Type | Individual
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Provider Name | ANNA LAUREL SHORT ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 5675 ROE BLVD STE 100
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City | ROELAND PARK
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State | KS
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Zip | 66205-2538
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Country | US
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Telephone | 913-432-2080
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Fax | 913-432-5183
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Provider Business Mailing Address
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Address Line | 5675 ROE BLVD STE 100
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City | ROELAND PARK
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State | KS
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Zip | 66205-2538
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Country | US
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Telephone | 913-432-2080
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Fax | 913-432-5183
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 53-75214-101
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-75214-101
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License Number State | KS
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