Provider Demographics
NPI:1144432675
Name:BISHOP, ELLENA F (LVN)
Entity type:Individual
Prefix:MRS
First Name:ELLENA
Middle Name:F
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 COUNTY ROAD 2704
Mailing Address - Street 2:
Mailing Address - City:MICO
Mailing Address - State:TX
Mailing Address - Zip Code:78056
Mailing Address - Country:US
Mailing Address - Phone:830-612-2853
Mailing Address - Fax:830-612-2853
Practice Address - Street 1:261 COUNTY ROAD 2704
Practice Address - Street 2:
Practice Address - City:MICO
Practice Address - State:TX
Practice Address - Zip Code:78056
Practice Address - Country:US
Practice Address - Phone:830-612-2853
Practice Address - Fax:830-612-2853
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127216164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse