Individual
ANNA MARIE BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
15 CRATER LAKE AVE, MEDFORD, OR 97504-7444
(541) 770-5100
(541) 770-5070
Mailing address
15 CRATER LAKE AVE, MEDFORD, OR 97504-7444
(541) 770-5100
(541) 770-5070
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
201606029RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10016662
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001662
APRN-NP LICENSE NUMBER
OR
Enumeration date
02/27/2019
Last updated
09/24/2024
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