National Provider Identifier
Johannah Shortle
Johannah Shortle is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Trumansburg, NY and a listed phone number of (607) 387-5707.
Profile Overview
- NPI
- 1336664655
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- August 08, 2017
- Last Updated
- August 08, 2017
Practice Location
- 4435 Seneca RD
- Trumansburg, NY 14886-9201
Phone: (607) 387-5707
Mailing Address
- 651 Ridge RD Apt B4
- Lansing, NY 14882-8866
Specialties
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1336664655
- Entity Type
- Individual
- Last Name
- Shortle
- First Name
- Johannah
- Mailing Street Address
- 651 Ridge RD Apt B4
- Mailing City
- Lansing
- Mailing State
- NY
- Mailing ZIP Code
- 14882-8866
- Mailing Country
- US
- Practice Street Address
- 4435 Seneca RD
- Practice City
- Trumansburg
- Practice State
- NY
- Practice ZIP Code
- 14886-9201
- Practice Country
- US
- Practice Phone
- (607) 387-5707
- Enumeration Date
- August 08, 2017
- Last Updated
- August 08, 2017
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X)