Provider Demographics
NPI:1962817528
Name:SHORT, DANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:SHORT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 W PARKER RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4673
Mailing Address - Country:US
Mailing Address - Phone:828-655-2570
Mailing Address - Fax:828-438-1991
Practice Address - Street 1:149 W PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4673
Practice Address - Country:US
Practice Address - Phone:828-655-2570
Practice Address - Fax:828-438-1991
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007027363LF0000X
NC210482363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health