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MS. STACI FAYE BISHOP PAC
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1922176643
Individual Registrant:MS. STACI FAYE BISHOP PAC
Gender: F
Not Sole Proprietor
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
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
Tel: 719-523-6628 Fax: 719-523-4513
Registration Information:
NPI: 1922176643
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | CO | PA849 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 07008493 | CO | 05 |
