Provider Demographics
NPI:1003455635
Name:BISHOP, KIMBERLY BROOKE (NP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BROOKE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:BROOKE
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:830 S BUNCOMBE RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-2400
Mailing Address - Country:US
Mailing Address - Phone:864-797-8500
Mailing Address - Fax:
Practice Address - Street 1:830 S BUNCOMBE RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2400
Practice Address - Country:US
Practice Address - Phone:864-797-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine