Provider Demographics
NPI:1649920703
Name:BISHOP, JODY L (NP)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:L
Last Name:BISHOP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:738 SHELBY FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-5527
Mailing Address - Country:US
Mailing Address - Phone:205-440-3773
Mailing Address - Fax:
Practice Address - Street 1:445 DEXTER AVE STE 4050
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-3867
Practice Address - Country:US
Practice Address - Phone:855-479-4217
Practice Address - Fax:888-557-9724
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-176780163WH0200X, 363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse