Healthcare Provider Details

I. General information

NPI: 1649720228
Provider Name (Legal Business Name): JENNIFER ANN BISHOP CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 V TWIN DR SUITE 204
GETTYSBURG PA
17325-7875
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-398-0786
  • Fax: 717-334-6659
Mailing address:
  • Phone: 717-334-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN343056L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016729
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: