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NPI 1144432675

NPI 1144432675 : ELLENA F. BISHOP L.V.N. : MICO, TX

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General NPI Number Information
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    NPI Number           |    1144432675
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    Entity Type          |    Individual 
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    Provider Name        |    ELLENA F. BISHOP L.V.N.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/04/2007
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    261 COUNTY ROAD 2704 
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    City                 |    MICO
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    State                |    TX
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    Zip                  |    78056
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    Country              |    US
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    Telephone            |    830-612-2853
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    Fax                  |    830-612-2853
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Provider Business Mailing Address
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    Address Line         |    261 COUNTY ROAD 2704 
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    City                 |    MICO
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    State                |    TX
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    Zip                  |    78056
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    Country              |    US
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    Telephone            |    830-612-2853
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    Fax                  |    830-612-2853
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    164X00000X
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    Taxonomy Name        |    Licensed Vocational Nurse
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    License Number       |    127216
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    License Number State |    TX
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