Provider Demographics
NPI:1811548860
Name:SHORTT, JOCELYNN ASHLEE (RN)
Entity Type:Individual
Prefix:MISS
First Name:JOCELYNN
Middle Name:ASHLEE
Last Name:SHORTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 MANSIONS BLFS APT 1307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-4132
Mailing Address - Country:US
Mailing Address - Phone:830-377-7150
Mailing Address - Fax:
Practice Address - Street 1:5565 MANSIONS BLFS APT 1307
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-4132
Practice Address - Country:US
Practice Address - Phone:830-377-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-21
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX894986163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse