1801205885 NPI number — SHARAE LIANA BISCHOFF APRN, CNM

Table of content: SHARAE LIANA BISCHOFF APRN, CNM (NPI 1801205885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801205885 NPI number — SHARAE LIANA BISCHOFF APRN, CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BISCHOFF
Provider First Name:
SHARAE
Provider Middle Name:
LIANA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801205885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3200 CANYON LAKE DR., MAILBOX
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAPID CITY
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-342-7400
Provider Business Mailing Address Fax Number:
605-716-4735

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 MOUNTAIN VIEW ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POWELL
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82435-2212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-754-7257
Provider Business Practice Location Address Fax Number:
314-467-4448
Provider Enumeration Date:
08/04/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  CM000124 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: APRN-177139 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 1337 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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