Provider Demographics
NPI:1588924732
Name:BISHOP, ANITA LYNNE (LPN)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:LYNNE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 FORESTER DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1101
Mailing Address - Country:US
Mailing Address - Phone:513-319-6055
Mailing Address - Fax:
Practice Address - Street 1:1359 FORESTER DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1101
Practice Address - Country:US
Practice Address - Phone:513-319-6055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN128359164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse