Patricia Short

Individual provider Active NPI Home Health Registered Nurse · Fredonia, KS

NPI 1255499232 · NPPES record last updated Dec 3, 2010

Key facts

NPI
1255499232
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
13-62-84-061 (KS)
Practice address
429 S 20TH St
Fredonia, KS 66736-1753
Phone
(620) 378-3525
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 13-62-84-061 KS Yes

Addresses

Primary practice location

429 S 20TH St
Fredonia, KS 66736-1753

Mailing address

429 S 20TH St
Fredonia, KS 66736-1753
Phone (620) 378-3525

Other providers in Fredonia, KS

All providers in Fredonia, KS · Home Health Registered Nurse in Kansas

Sources for this page

Verify at the official NPI Registry.