Provider Demographics
NPI:1598901902
Name:ABBOTT, ELIZABETH O (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:O
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:CRNP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3701 MARKET STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2617
Mailing Address - Country:US
Mailing Address - Phone:215-662-3958
Mailing Address - Fax:212-342-1783
Practice Address - Street 1:3701 MARKET STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-6035
Practice Address - Fax:212-342-1783
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2012-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY42 420866363LW0102X
PASP010773363LW0102X
NY42420866363LW0102X
PARN612422363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health