Provider Demographics
NPI:1912214669
Name:BISHOP, LISA H (DNP)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:H
Last Name:BISHOP
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:H
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:30 BURTON HILLS BLVD
Mailing Address - Street 2:STE 175
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6403
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-208-1303
Practice Address - Street 1:1922 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4114
Practice Address - Country:US
Practice Address - Phone:662-236-2232
Practice Address - Fax:662-236-2264
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR857937363LF0000X
LAAP06705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09372747Medicaid
MS09372747Medicaid