Provider Demographics
NPI:1952688996
Name:BISHOP, KRISTEN LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LEIGH
Last Name:BISHOP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3304
Mailing Address - Country:US
Mailing Address - Phone:308-384-2626
Mailing Address - Fax:308-384-2983
Practice Address - Street 1:1230 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3304
Practice Address - Country:US
Practice Address - Phone:308-384-2626
Practice Address - Fax:308-384-2983
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist