Provider Demographics
NPI:1194726331
Name:YESBICK, ELIZABETH ANNE (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:YESBICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 WINIFRED RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4609
Mailing Address - Country:US
Mailing Address - Phone:229-883-1626
Mailing Address - Fax:
Practice Address - Street 1:2305 ROBINHOOD RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3271
Practice Address - Country:US
Practice Address - Phone:229-883-0237
Practice Address - Fax:229-435-7967
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA968647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily