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NPI Code Detail

MEDICARE: MRS. DENISSE C BISHARA FNP-C

MEDICARE: MRS. DENISSE C BISHARA FNP-C
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner110534WV

General Provider Information

NPI Number : 1336017417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENISSE C BISHARA FNP-C
Provider Business Mailing Address
First Line : 3100 MACCORKLE AVE SE STE 205
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1228
Country : US
Telephone Number : 304-388-2303
Fax Number : 304-388-2390
Provider Business Practice Location Address
First Line : 3100 MACCORKLE AVE SE STE 205
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1228
Country : US
Telephone Number : 304-388-2303
Fax Number : 304-388-2390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2025
Last Update Date : 04/07/2026

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Directions to “ MRS. DENISSE C BISHARA FNP-C” Practice Location

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