Healthcare Provider Details

I. General information

NPI: 1164068581
Provider Name (Legal Business Name): NODIE KAY BISHOP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 N. WATER ST.
DARBY MT
59829-9622
US

IV. Provider business mailing address

357 TIN CUP RD
DARBY MT
59829-9622
US

V. Phone/Fax

Practice location:
  • Phone: 406-821-1012
  • Fax:
Mailing address:
  • Phone: 406-821-4733
  • Fax: 406-821-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: