Provider Demographics
NPI:1134242365
Name:BISHOP, NANCY MIMS (RPH)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MIMS
Last Name:BISHOP
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 GREENCREST LN
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-1904
Mailing Address - Country:US
Mailing Address - Phone:334-365-3242
Mailing Address - Fax:
Practice Address - Street 1:120 GREENCREST LN
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-1904
Practice Address - Country:US
Practice Address - Phone:334-365-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist