Individual
AUDRA BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1601 CHERRY ST, PHILADELPHIA, PA 19102-1320
(267) 359-5741
Mailing address
PO BOX 27, DOUGLASSVILLE, PA 19518-0027
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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