MEDICARE: MS. LAURA ASHLEY SHORT APRN

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3014073	KY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	101.0138543TELE	VT
3	363LF0000X	Family Nurse Practitioner	3014073	KY
4	163W00000X	Registered Nurse	1135867	KY
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	16793	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F09191182	OTHER	KY	CERTIFICATION NUMBER

General Provider Information

NPI Number	:	1013553627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA ASHLEY SHORT APRN

Provider Business Mailing Address
First Line	:	336 HIGHLAND LAKES DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-3832
Country	:	US
Telephone Number	:	859-200-3404
Fax Number	:	859-545-4929

Provider Business Practice Location Address
First Line	:	336 HIGHLAND LAKES DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-3832
Country	:	US
Telephone Number	:	859-200-3404
Fax Number	:	859-545-4929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2019
Last Update Date	:	06/03/2026

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Directions to “ MS. LAURA ASHLEY SHORT APRN” Practice Location

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