Healthcare Provider Details

I. General information

NPI: 1275498396
Provider Name (Legal Business Name): JAIME BISCHOFF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4702 E LAFAYETTE BLVD
PHOENIX AZ
85018-3832
US

IV. Provider business mailing address

4702 E LAFAYETTE BLVD
PHOENIX AZ
85018-3832
US

V. Phone/Fax

Practice location:
  • Phone: 708-906-8989
  • Fax:
Mailing address:
  • Phone: 708-906-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN215388
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: