Provider Demographics
NPI:1114469616
Name:FARBOTNIK, ELIZABETH ANN GILLETTE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH ANN
Middle Name:GILLETTE
Last Name:FARBOTNIK
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:2655 NORTHWINDS PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2280
Mailing Address - Country:US
Mailing Address - Phone:678-690-7566
Mailing Address - Fax:404-751-5173
Practice Address - Street 1:16332 CONNEAUT LAKE RD
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3843
Practice Address - Country:US
Practice Address - Phone:814-337-3300
Practice Address - Fax:814-336-3740
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2022-01-31
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Provider Licenses
StateLicense IDTaxonomies
PASP016713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily