Provider Demographics
NPI:1952726820
Name:BISHOP, TRACY CHINITA (FAMILY CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:CHINITA
Last Name:BISHOP
Suffix:
Gender:F
Credentials:FAMILY CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PAINTERS MILL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5251
Mailing Address - Country:US
Mailing Address - Phone:410-356-4680
Mailing Address - Fax:
Practice Address - Street 1:110 PAINTERS MILL RD STE 206
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5251
Practice Address - Country:US
Practice Address - Phone:410-356-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR154217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily