Provider Demographics
NPI:1679982060
Name:BISHOP, DAWN MICHELE (APRN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20375 W 151ST ST
Mailing Address - Street 2:350
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5306
Mailing Address - Country:US
Mailing Address - Phone:913-829-0446
Mailing Address - Fax:913-829-7629
Practice Address - Street 1:20375 W 151ST ST
Practice Address - Street 2:350
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5306
Practice Address - Country:US
Practice Address - Phone:913-829-0446
Practice Address - Fax:913-829-7629
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS033D00112Medicare PIN