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General NPI Number Information
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NPI Number | 1407719792
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Entity Type | Individual
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Provider Name | GABRIELA ELIZARRARAS CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 215-590-1653
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 CHESTNUT ST APT 806
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3759
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Country | US
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Telephone | 215-596-0015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | SP034562
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License Number State | PA
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