Provider Demographics
NPI:1508029828
Name:SHORT, LINDSAY J (FNP)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:J
Last Name:SHORT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 SENATOR KEATING BLVD
Mailing Address - Street 2:BLDG E SUITE 330
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2775
Mailing Address - Country:US
Mailing Address - Phone:585-232-2980
Mailing Address - Fax:585-232-6522
Practice Address - Street 1:995 SENATOR KEATING BLVD
Practice Address - Street 2:BLDG E SUITE 330
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2775
Practice Address - Country:US
Practice Address - Phone:585-232-2980
Practice Address - Fax:585-232-6522
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335555363LF0000X
NY335555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00028588001OtherUNIVERA
NY234908FZOtherMVP
NY9515338OtherIHA
NY000934196001OtherBCBS
NY02986354Medicaid
NYJ400001144Medicare PIN