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NPI Code Detail

MEDICARE: MS. LAURA ASHLEY SHORT APRN

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
1363L00000XNurse Practitioner1135867KY
2363LF0000XFamily Nurse Practitioner3014073KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F09191182OTHERKYCERTIFICATION 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 : 2200 JEFFERSON AVE FL 5
Second Line :
City : TOLEDO
State : OH
Zip : 43604-7102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 103 KEYSTONE DR
Second Line :
City : RICHMOND
State : KY
Zip : 40475-7988
Country : US
Telephone Number : 859-353-8884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2019
Last Update Date : 05/27/2020

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

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