Provider Demographics
NPI: | 1508088345 |
---|---|
Name: | BISHOP, TERRI (CNM, ARNP) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | TERRI |
Middle Name: | |
Last Name: | BISHOP |
Suffix: | |
Gender: | F |
Credentials: | CNM, ARNP |
Other - Prefix: | MRS |
Other - First Name: | THERESA |
Other - Middle Name: | BISHOP |
Other - Last Name: | WHITEHURST |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | CNM, ARNP |
Mailing Address - Street 1: | 1128 MAGNOLIA AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | PANAMA CITY |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32401 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 850-258-1514 |
Mailing Address - Fax: | 850-747-8001 |
Practice Address - Street 1: | 7051 SOUTHPOINT PKWY S STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | JACKSONVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32216 |
Practice Address - Country: | US |
Practice Address - Phone: | 904-493-2229 |
Practice Address - Fax: | 904-396-4546 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-05-02 |
Last Update Date: | 2018-08-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ARNP 9201376 | 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | ARNP 9201376 | Other | FL LICENSE NUMBER |
CERTIFICATION# 11137 | Other | AMER. MIDWIFERY CERT. BD. |