Provider Demographics
NPI:1427372663
Name:BISCHOF, JOHANNA ELISABETH
Entity Type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:ELISABETH
Last Name:BISCHOF
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 1:8344 APPLEBROOK TER
Mailing Address - Street 2:APT L1
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-1842
Mailing Address - Country:US
Mailing Address - Phone:919-971-9900
Mailing Address - Fax:
Practice Address - Street 1:8344 APPLEBROOK TER
Practice Address - Street 2:APT L1
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-1842
Practice Address - Country:US
Practice Address - Phone:919-971-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program