Provider Demographics
NPI:1972982866
Name:BISHOP, DEANNA ELLEN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:ELLEN
Last Name:BISHOP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:DEANNA
Other - Middle Name:ELLEN
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BX 632040
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75963
Mailing Address - Country:US
Mailing Address - Phone:936-560-5413
Mailing Address - Fax:936-552-7240
Practice Address - Street 1:1309 S. UNIVERSITY DR
Practice Address - Street 2:EAST TEXAS COMMUNITY HEALTH SERVICES, INC.
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961
Practice Address - Country:US
Practice Address - Phone:936-560-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-25
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily