Provider Demographics
NPI:1669493383
Name:FABRIZIO, ELISABETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:FABRIZIO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4193
Mailing Address - Fax:615-425-4201
Practice Address - Street 1:12167 SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2417
Practice Address - Country:US
Practice Address - Phone:303-658-9807
Practice Address - Fax:303-658-9808
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106292363L00000X
COAPN.0004490-NP363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03024369Medicaid
COCO305528Medicare PIN
CO305528Medicare PIN