Healthcare Provider Details

I. General information

NPI: 1649920703
Provider Name (Legal Business Name): JODY L BISHOP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/02/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2318 HIGHWAY 36
CHELSEA AL
35043-5447
US

IV. Provider business mailing address

2318 HIGHWAY 36
CHELSEA AL
35043-5447
US

V. Phone/Fax

Practice location:
  • Phone: 205-440-3773
  • Fax:
Mailing address:
  • Phone: 205-440-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-176780
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-176780
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-176780
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: