Provider Demographics
NPI:1588727283
Name:BISHOP, NORAH K (PT)
Entity type:Individual
Prefix:
First Name:NORAH
Middle Name:K
Last Name:BISHOP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2948
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-2948
Mailing Address - Country:US
Mailing Address - Phone:575-737-0715
Mailing Address - Fax:575-737-0601
Practice Address - Street 1:111 DONA ANA DR
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:575-737-0715
Practice Address - Fax:575-737-0601
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM50700383Medicaid
NMNM00NR36OtherBLUE CROSS BLUE SHIELD
NMNM00NR36OtherBLUE CROSS BLUE SHIELD