Provider Demographics
NPI:1245659978
Name:BISHOP, RONNAH (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:RONNAH
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 E 32ND ST
Mailing Address - Street 2:P.O. BOX 4039
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2703
Mailing Address - Country:US
Mailing Address - Phone:512-544-0432
Mailing Address - Fax:512-544-4337
Practice Address - Street 1:919 E 32ND ST
Practice Address - Street 2:FOOD AND NUTRITION DEPARTMENT
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2703
Practice Address - Country:US
Practice Address - Phone:512-544-0432
Practice Address - Fax:512-544-4337
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04439133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered