MEDICARE: MS. CANDACE J BISHOP NP

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
1	163W00000X	Registered Nurse	8378	TN
2	363LF0000X	Family Nurse Practitioner	8378	TN

General Provider Information

NPI Number	:	1518947134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CANDACE J BISHOP NP

Provider Business Mailing Address
First Line	:	103 CHEROKEE BLVD
Second Line	:	SUITE E
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-3857
Country	:	US
Telephone Number	:	423-756-1506
Fax Number	:	423-495-1909

Provider Business Practice Location Address
First Line	:	3905 HIXSON PIKE STE 103
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-3569
Country	:	US
Telephone Number	:	423-756-1506
Fax Number	:

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	05/05/2020

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