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Individual

MRS. CASSIE L BISHOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
523 W MAIN ST, THOMASTON, GA 30286-3504
(706) 647-9638
(706) 647-5321
Mailing address
523 W MAIN ST, THOMASTON, GA 30286-3504
(706) 647-9638
(706) 647-5321

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN201329
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003161623A
GA
01
GRP2439
MEDICARE GROUP
GA
Enumeration date
07/17/2014
Last updated
08/24/2015
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