Provider Demographics
NPI:1649526641
Name:BISHOP, ELIZABETH B (RD LD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:B
Last Name:BISHOP
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6344 S DEVONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4750 WESLEY AVE STE J
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2276
Practice Address - Country:US
Practice Address - Phone:513-458-8859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD 3633133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered