Provider Demographics
NPI:1134866205
Name:BISHOP, ASHLEY BREANNA (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BREANNA
Last Name:BISHOP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 THIRD AVENUE
Mailing Address - Street 2:FRNT A #1666
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-7604
Mailing Address - Country:US
Mailing Address - Phone:718-930-8199
Mailing Address - Fax:
Practice Address - Street 1:800 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-7604
Practice Address - Country:US
Practice Address - Phone:718-930-8199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1631973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily