Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 008441 | CT |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 8441 | CT |
NPI | 1306494026 |
---|---|
Provider Name | Ms. Laura Anne Bishop |
First Address | Farmington, CT 06030-0001 |
Second Address | Farmington, CT 06030-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2019 |
Last Update Date | 25/09/2019 |