Basic Information
| Provider Information | |||||||||
| NPI: | 1790263366 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BISHOP | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | WHITNEY | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | WHITNEY | ||||||||
| OtherFirstName: | HANNAH | ||||||||
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| OtherCredential: | RN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2709 HEMLOCK ST | ||||||||
| Address2: | |||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983102623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603732547 | ||||||||
| FaxNumber: | 3608253370 | ||||||||
| Practice Location | |||||||||
| Address1: | 2709 HEMLOCK ST | ||||||||
| Address2: | |||||||||
| City: | BREMERTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983102623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603732547 | ||||||||
| FaxNumber: | 3608253370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2018 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP60883381 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207RC0000X | MD00028605 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 2108498 | 05 | WA | MEDICAID |