Jennifer Michelle Short, | |
300 Corporate Center Drive, Scott Depot, WV 25560-9026 | |
(304) 691-6800 | |
(304) 691-6751 |
Full Name | Jennifer Michelle Short |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 300 Corporate Center Drive, Scott Depot, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437899622 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 112052 (West Virginia) | Primary |
Entity Name | St. Mary's Medical Management, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922155217 PECOS PAC ID: 5890897151 Enrollment ID: O20070216000690 |
Mailing Address | Practice Location Address |
---|---|
Jennifer Michelle Short, 1448 10th Avenue, Suite 304, Huntington, WV 25701-3579 Ph: (304) 691-6381 | Jennifer Michelle Short, 300 Corporate Center Drive, Scott Depot, WV 25560-9026 Ph: (304) 691-6800 |
Ms. Breann Hawley Thomas, WHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 97 Great Teays Blvd, Suite 6, Scott Depot, WV 25560 Phone: 304-757-6999 Fax: 304-201-5019 | |
James Nottingham, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Corporate Center Drive, Scott Depot, WV 25560 Phone: 304-691-6800 | |
Mrs. Dawn Lynn Grigsby, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 97 Great Teays Blvd, Ste 6, Scott Depot, WV 25560 Phone: 304-757-6999 Fax: 304-757-3252 | |
Annette Gaskins, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 97 Great Teays Blvd, Suite 6, Scott Depot, WV 25560 Phone: 304-757-6999 Fax: 304-757-3252 | |
Jessica Allen, APRN-FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 111 Great Teays Blvd, Scott Depot, WV 25560 Phone: 304-757-8459 Fax: 304-757-6904 | |
Gina Lee Lathey, APRN FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 Corporate Center Drive, Scott Depot, WV 25560 Phone: 304-691-6800 | |
Lydia Smith, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 112 Quarterhorse Dr, Scott Depot, WV 25560 Phone: 304-685-1901 |