Provider Demographics
NPI:1023679404
Name:BISHOP, DANYELL (NP)
Entity type:Individual
Prefix:
First Name:DANYELL
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DR STE 2300
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 EAST AVE STE C
Practice Address - Street 2:
Practice Address - City:PILESGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08098-1351
Practice Address - Country:US
Practice Address - Phone:856-769-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001241363LF0000X
NJ26NJ00930700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily