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NPI Code Detail

MEDICARE: ELIZABETH ABANDO RN, IBCLC, FNP-BC

MEDICARE: ELIZABETH ABANDO RN, IBCLC, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024187817VA
2163W00000XRegistered Nurse0001158214VA

General Provider Information

NPI Number : 1366053332
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ABANDO RN, IBCLC, FNP-BC
Provider Business Mailing Address
First Line : PO BOX 37174
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3174
Country : US
Telephone Number : 571-423-5699
Fax Number : 571-423-5698
Provider Business Practice Location Address
First Line : 8280 WILLOW OAKS CORPORATE DR STE 300
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4526
Country : US
Telephone Number : 571-472-4300
Fax Number : 571-665-6771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2020
Last Update Date : 11/17/2025

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