Provider Demographics
NPI:1073810487
Name:BISHOP, ELAINE R (CNM)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:R
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 PARK WEST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4218
Mailing Address - Country:US
Mailing Address - Phone:330-869-9777
Mailing Address - Fax:330-865-6011
Practice Address - Street 1:1 PARK WEST BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4218
Practice Address - Country:US
Practice Address - Phone:330-869-9777
Practice Address - Fax:330-865-6011
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN316327367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH316327OtherRN LICENSE