Individual
MR. KEVIN BLAKE BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN NP-C
Contact information
Practice address
1600 MEDICAL CENTER DR STE 1500, HUNTINGTON, WV 25701-3657
(304) 691-1100
Mailing address
1500 HIGHVIEW DR, ASHLAND, KY 41102-9663
(606) 547-5395
(606) 547-5395
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3011515
KY
363LF0000X
Family Nurse Practitioner
Primary
104052
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3011515
KENTUCKY BOARD OF NURSING
KY
Enumeration date
09/26/2017
Last updated
11/23/2021
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