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MS. STACI FAYE BISHOP PAC

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1922176643

Individual Registrant:
MS. STACI FAYE BISHOP PAC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
373 EAST 10TH AVENUE  SPRINGFIELD, CO 81073-0000 US
Tel: 719-523-6628  Fax: 719-523-4513

Contact information for business:
373 EAST 10TH AVENUE  SPRINGFIELD, CO 81073-0000 US
Tel: 719-523-6628  Fax: 719-523-4513

Registration Information:
NPI: 1922176643
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
COPA849

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
07008493CO05




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