Individual
DR. JENNIFER DIANE BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 UNSER BLVD NE, 1ST FLOOR, 2ND TOWER, RIO RANCHO, NM 87124
(505) 559-6100
(505) 462-8792
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
050450
CT
208600000X
Surgery Physician
Primary
MD2016-0573
NM
Other
Enumeration date
07/17/2008
Last updated
10/19/2016
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