Individual provider · Type 1 NPI

Kristopher Mitchell Short

Gerontology Nurse Practitioner · St. Joseph, MO

NPI number 1215671128 Active

Practice location

5325 Faraon St
St. Joseph, MO 64506-3488

Fax (816) 271-7986

Mailing address

5301 Faraon St Ste 120
St. Joseph, MO 64506-3512

Specialties and licenses

TaxonomyCodeLicense
Critical Care Medicine Registered Nurse 163WC0200X2003020380 (MO)
Nurse Practitioner 363L00000X2022024067 (MO)
Gerontology Nurse Practitioner Primary 363LG0600X2022024067 (MO)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1215671128

Kristopher Mitchell Short's National Provider Identifier is 1215671128, issued on Apr 26, 2022. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in St. Joseph, MO. The record was last updated on Oct 9, 2024.