Individual
JOHNNA RALONN SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
150 THOMPSON DR STE 101, BRIDGEPORT, WV 26330-1644
(304) 599-8003
(304) 599-8003
Mailing address
1247 SUNCREST TOWN CENTRE DR, MORGANTOWN, WV 26505-1876
(304) 599-8000
(304) 599-8003
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
108483
WV
Other
Enumeration date
06/04/2021
Last updated
01/27/2026
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