Vickie Diane Short, RN
Individual provider Active NPI Registered Nurse · Albion, IL
NPI 1174882765 · NPPES record last updated May 16, 2012
Key facts
- NPI
- 1174882765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 041389613 (IL)
- Practice address
- 33 W Main St
Albion, IL 62806-1006 - Phone
- (618) 445-2287
- NPI assigned
- May 16, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041389613 | IL | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041389613 | IL | Yes |
Addresses
Primary practice location
33 W Main St
Albion, IL 62806-1006
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2436
Other providers in Albion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.