Provider Demographics
NPI:1851461891
Name:HARRISON-SHORT, KATHERINE JEAN (CNM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JEAN
Last Name:HARRISON-SHORT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:JEAN
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,CNM
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:
Practice Address - Street 1:313 E 12TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1954
Practice Address - Country:US
Practice Address - Phone:512-324-8670
Practice Address - Fax:512-324-8671
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253950367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife