Provider Demographics
NPI:1043853518
Name:BISHOP, VIRGINIA A (LD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 ROMANS DR
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-5854
Mailing Address - Country:US
Mailing Address - Phone:423-482-5016
Mailing Address - Fax:
Practice Address - Street 1:1215 ROMANS DR
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-5854
Practice Address - Country:US
Practice Address - Phone:423-397-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker