Provider Demographics
NPI:1679114821
Name:BISHOP, CYNTHIA (FNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 DRIVE 1341
Mailing Address - Street 2:
Mailing Address - City:MOOREVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38857-7426
Mailing Address - Country:US
Mailing Address - Phone:662-523-5875
Mailing Address - Fax:
Practice Address - Street 1:351 PEOPLES DR
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-8990
Practice Address - Country:US
Practice Address - Phone:662-489-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily