Provider Demographics
NPI:1013682178
Name:BISHOP, JESSICA L (AUD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:BISHOP
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2793
Mailing Address - Country:US
Mailing Address - Phone:502-371-9910
Mailing Address - Fax:502-515-3325
Practice Address - Street 1:108 W DAISY LN
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4537
Practice Address - Country:US
Practice Address - Phone:812-945-3557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002829A231H00000X
KY278747231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist