Provider Demographics
NPI:1346698487
Name:BISHOP, LORETTA (CM/RN)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CM/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50539 ALTMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4422
Mailing Address - Country:US
Mailing Address - Phone:586-744-9698
Mailing Address - Fax:
Practice Address - Street 1:50539 ALTMAN RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-4422
Practice Address - Country:US
Practice Address - Phone:586-744-9698
Practice Address - Fax:248-745-0396
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator