Provider Demographics
NPI:1699225532
Name:BISCHOFF, LORETTA L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:L
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:LORETTA
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-0236
Mailing Address - Country:US
Mailing Address - Phone:812-932-3371
Mailing Address - Fax:812-932-3506
Practice Address - Street 1:256 STATE ROAD 129 S
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-9236
Practice Address - Country:US
Practice Address - Phone:812-932-4700
Practice Address - Fax:812-933-5144
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020219363LF0000X
IN71006783A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300000122Medicaid
IN300000122Medicaid