Provider Demographics
NPI:1295006385
Name:ABERNATHY, ELIZABETH DAMERON (ATC, CES)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DAMERON
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7195 HUNTERS BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8054
Mailing Address - Country:US
Mailing Address - Phone:704-763-0308
Mailing Address - Fax:
Practice Address - Street 1:7195 HUNTERS BLUFF DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8054
Practice Address - Country:US
Practice Address - Phone:704-763-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer