Provider Demographics
NPI:1326421488
Name:BISHOP, RACHEL (CM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 S KOMAS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1215
Mailing Address - Country:US
Mailing Address - Phone:801-581-5515
Mailing Address - Fax:801-587-3980
Practice Address - Street 1:650 S KOMAS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1215
Practice Address - Country:US
Practice Address - Phone:801-581-5515
Practice Address - Fax:801-587-3980
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator