Individual
MS. STACI FAYE BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
373 EAST 10TH AVENUE, SPRINGFIELD, CO 81073-0000
(719) 523-6628
(719) 523-4513
Mailing address
373 EAST 10TH AVENUE, SPRINGFIELD, CO 81073-0000
(719) 523-6628
(719) 523-4513
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA849
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07008493
—
CO
Enumeration date
12/01/2006
Last updated
04/24/2013
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