Provider Demographics
NPI:1093488124
Name:BISHOP, EDELYN YVETTE (APRN PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:EDELYN
Middle Name:YVETTE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:APRN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 KEY LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-8141
Mailing Address - Country:US
Mailing Address - Phone:860-918-5889
Mailing Address - Fax:
Practice Address - Street 1:8420 KEY LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-8141
Practice Address - Country:US
Practice Address - Phone:860-918-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29959363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN29959OtherAPRN LICENSE NUMBER