Provider Demographics
NPI:1972175792
Name:BISHIR, RACHEL LYNN (LPN)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LYNN
Last Name:BISHIR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SAINT JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-1983
Mailing Address - Country:US
Mailing Address - Phone:765-450-9842
Mailing Address - Fax:
Practice Address - Street 1:800 SAINT JOSEPH DR
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-1983
Practice Address - Country:US
Practice Address - Phone:765-450-9842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27048722A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse