Provider Demographics
NPI:1134417488
Name:BISHOP, WESLEIGH ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:WESLEIGH
Middle Name:ANN
Last Name:BISHOP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:WESLEIGH
Other - Middle Name:ANN
Other - Last Name:JASTORFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:327 CEDAR CIR
Mailing Address - Street 2:PHARMACY
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-2739
Mailing Address - Country:US
Mailing Address - Phone:605-641-7481
Mailing Address - Fax:
Practice Address - Street 1:1100 N SAINT FRANCIS ST STE 200
Practice Address - Street 2:PHARMACY
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2866
Practice Address - Country:US
Practice Address - Phone:316-268-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5871183500000X
KS1-154221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist