Provider Demographics
NPI:1437622180
Name:BISHOP, RICHARD (PERSONAL CARE GIVER)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:BISHOP
Suffix:
Gender:M
Credentials:PERSONAL CARE GIVER
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PERSONAL CARE GIVER
Mailing Address - Street 1:7465 W LAKE MEAD BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1033
Mailing Address - Country:US
Mailing Address - Phone:702-521-9097
Mailing Address - Fax:
Practice Address - Street 1:7465 W LAKE MEAD BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1033
Practice Address - Country:US
Practice Address - Phone:702-521-9097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-05
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant