Provider Demographics
NPI:1508999541
Name:SHORTALL, ANN MURRAY ABERNETHY (RN, NP)
Entity Type:Individual
Prefix:MRS
First Name:ANN MURRAY
Middle Name:ABERNETHY
Last Name:SHORTALL
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MURRAY
Other - Last Name:ABERNETHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 PINHEIRO CIR
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-6817
Mailing Address - Country:US
Mailing Address - Phone:205-908-2946
Mailing Address - Fax:415-922-9418
Practice Address - Street 1:1500 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4523
Practice Address - Country:US
Practice Address - Phone:415-474-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000157275163W00000X
CANP18014363LP0808X
CARN705137163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse