Provider Demographics
NPI:1447705173
Name:ALBRITTON, ELIZABETH KATE (FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KATE
Last Name:ALBRITTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 MEADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELLAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31806-8935
Mailing Address - Country:US
Mailing Address - Phone:229-331-1936
Mailing Address - Fax:
Practice Address - Street 1:339 S BROAD ST
Practice Address - Street 2:
Practice Address - City:ELLAVILLE
Practice Address - State:GA
Practice Address - Zip Code:31806
Practice Address - Country:US
Practice Address - Phone:229-391-8680
Practice Address - Fax:229-937-2232
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN216550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MF4185977OtherDEA NUMBER