Provider Demographics
NPI:1447736939
Name:SHORT, TAYLOR LYNN (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:LYNN
Last Name:SHORT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1004
Mailing Address - Country:US
Mailing Address - Phone:419-720-7883
Mailing Address - Fax:
Practice Address - Street 1:313 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1004
Practice Address - Country:US
Practice Address - Phone:419-720-7883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2483363LF0000X
OHCNP025404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily