Provider Demographics
NPI:1013964857
Name:GRABOWSKI, ELIZABETH M (ARNP, BC-ADM, FAAN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:ARNP, BC-ADM, FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6337
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-0337
Mailing Address - Country:US
Mailing Address - Phone:502-895-2334
Mailing Address - Fax:502-896-6987
Practice Address - Street 1:4010 DANA RD
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-9224
Practice Address - Country:US
Practice Address - Phone:502-895-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3001795364SM0705X
KY1795S364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78000387Medicaid
KYS48957Medicare UPIN
KY78000387Medicaid