Provider Demographics
NPI:1639565724
Name:BISHOP, AMY D (CNS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:BISHOP
Suffix:
Gender:
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 JASONWAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-4359
Mailing Address - Country:US
Mailing Address - Phone:614-442-3130
Mailing Address - Fax:614-442-3150
Practice Address - Street 1:810 JASONWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4359
Practice Address - Country:US
Practice Address - Phone:614-442-3130
Practice Address - Fax:614-442-3145
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNS.17149364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0127082Medicaid