Individual
VIRGINIA SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
514 W ATLANTIC ST, SOUTH HILL, VA 23970-1906
(434) 584-2000
(434) 447-2240
Mailing address
514 W ATLANTIC ST, SOUTH HILL, VA 23970-1906
(434) 584-2000
(434) 447-2240
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024168641
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457675720
NPI
VA
05
—
1457675720
—
VA
Enumeration date
03/16/2010
Last updated
01/13/2017
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