Healthcare Provider Details

I. General information

NPI: 1801205885
Provider Name (Legal Business Name): SHARAE LIANA BISCHOFF APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 MOUNTAIN VIEW ST
POWELL WY
82435-2212
US

IV. Provider business mailing address

3200 CANYON LAKE DR., MAILBOX
RAPID CITY SD
57702
US

V. Phone/Fax

Practice location:
  • Phone: 307-754-7257
  • Fax: 314-467-4448
Mailing address:
  • Phone: 605-342-7400
  • Fax: 605-716-4735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCM000124
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN-177139
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1337
License Number StateWY
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: