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Individual

MR. DANA J BISHOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
22 MASONIC AVENUE, WALLINGFORD, CT 06492
(203) 679-6585
(203) 679-6873
Mailing address
PO BOX 70, 62 BRADFORD WALK, FARMINGTON, CT 06032
(860) 284-0533

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
001801
CT
363LP2300X
Primary Care Nurse Practitioner
001801
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528224714
CT
Enumeration date
08/06/2008
Last updated
08/07/2017
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