Provider Demographics
NPI:1770255408
Name:BISHOP, SAMANTHA RHEA (NP-BC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:RHEA
Last Name:BISHOP
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:RHEA
Other - Last Name:GALLIMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 639994
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9994
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6053
Practice Address - Country:US
Practice Address - Phone:804-741-6200
Practice Address - Fax:804-741-6213
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001259478163W00000X
VA0024183435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse