Provider Demographics
NPI:1497472955
Name:SHORT, CHRISTY (PMHNP-BC, APRN, MSN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:SHORT
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2102
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1510
Mailing Address - Country:US
Mailing Address - Phone:720-391-2666
Mailing Address - Fax:
Practice Address - Street 1:309 JERRY ST STE 108
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2442
Practice Address - Country:US
Practice Address - Phone:720-391-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998152-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health