Provider Demographics
NPI:1528239464
Name:WHITE SHORT, ELIZABETH (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WHITE SHORT
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 SUMMER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2858
Mailing Address - Country:US
Mailing Address - Phone:901-382-5256
Mailing Address - Fax:901-382-3731
Practice Address - Street 1:2743 SUMMER OAKS DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2858
Practice Address - Country:US
Practice Address - Phone:901-382-5256
Practice Address - Fax:901-382-3731
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000013352OtherTN APN
TN0000150630OtherRN