Provider Demographics
NPI:1306191572
Name:BISHOP, STACI (CD)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6156 S MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-4003
Mailing Address - Country:US
Mailing Address - Phone:205-706-9505
Mailing Address - Fax:
Practice Address - Street 1:2608 RIVER MEADE WAY
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-1187
Practice Address - Country:US
Practice Address - Phone:205-706-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula