| NPI | 1861968133 |
|---|---|
| Former Name | ALLEN JESSEE BISHOP |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NV RN98594) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2017018571) |
| 164W00000X Licensed Practical Nurse (Licence: MO 2012023992) | |
| 164W00000X Licensed Practical Nurse (Licence: NV 812644) | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |