=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891815726
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIMBERLY BISHOP RN, MSN, CCNS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 19TH ST S
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35233-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-933-8101
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5639 DUG HOLLOW RD
-----------------------------------------------------
City | PINSON
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35126-4432
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-680-6557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC1600X
-----------------------------------------------------
Taxonomy Name | Continuing Education/Staff Development Registered Nurse
-----------------------------------------------------
License Number | 1-088258
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------