Provider Demographics
NPI:1144899758
Name:BISHOP, ESTEE ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:ESTEE
Middle Name:ELIZABETH
Last Name:BISHOP
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ESTEE
Other - Middle Name:ELIZABETH
Other - Last Name:SIEBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:14937 SNOWY OWL ST NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-4395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14937 SNOWY OWL ST NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-4395
Practice Address - Country:US
Practice Address - Phone:763-489-8896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered