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General NPI Number Information
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NPI Number | 1326476599
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Entity Type | Individual
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Provider Name | MELISSA DANIELLE BISHOP PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/24/2013
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 714 LYNDON LN STE 6
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City | LOUISVILLE
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State | KY
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Zip | 40222-4643
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Country | US
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Telephone | 502-655-9744
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Fax | 502-653-7428
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Provider Business Mailing Address
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Address Line | 1911 BELAY WAY
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City | LOUISVILLE
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State | KY
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Zip | 40245-5450
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Country | US
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Telephone | 502-655-9744
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Fax | 502-653-7428
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3008816
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License Number State | KY
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