MEDICARE: SAMANTHA DAWN BISHOP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1316735228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA DAWN BISHOP

Provider Business Mailing Address
First Line	:	504 SAINT CLARE AVE
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-3086
Country	:	US
Telephone Number	:	308-482-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	504 SAINT CLARE AVE
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-3086
Country	:	US
Telephone Number	:	308-482-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	04/29/2025

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Directions to “ SAMANTHA DAWN BISHOP ” Practice Location

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