Provider Demographics
NPI:1053514539
Name:BISHOP, GRETCHEN (CRNP)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:
Other - Last Name:SAELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 MEDICAL CENTER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHICORA
Mailing Address - State:PA
Mailing Address - Zip Code:16025-2612
Mailing Address - Country:US
Mailing Address - Phone:724-445-3561
Mailing Address - Fax:724-445-7446
Practice Address - Street 1:160 MEDICAL CENTER RD STE A
Practice Address - Street 2:
Practice Address - City:CHICORA
Practice Address - State:PA
Practice Address - Zip Code:16025-2612
Practice Address - Country:US
Practice Address - Phone:724-445-3561
Practice Address - Fax:724-445-7446
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN317745L163W00000X
PASP011900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ39563Medicare UPIN
PA089281RN0Medicare PIN