Provider Demographics
NPI:1164068581
Name:BISHOP, NODIE KAY
Entity Type:Individual
Prefix:
First Name:NODIE
Middle Name:KAY
Last Name:BISHOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 TIN CUP RD
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:MT
Mailing Address - Zip Code:59829-9622
Mailing Address - Country:US
Mailing Address - Phone:406-821-4733
Mailing Address - Fax:406-821-4733
Practice Address - Street 1:1160 N. WATER ST.
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:MT
Practice Address - Zip Code:59829-9622
Practice Address - Country:US
Practice Address - Phone:406-821-1012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health