Provider Demographics
NPI:1366053332
Name:ABANDO, ELIZABETH (RN, IBCLC, FNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ABANDO
Suffix:
Gender:F
Credentials:RN, IBCLC, FNP-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BASAN
Other - Last Name:ISIDOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8280 WILLOW OAKS CORPORATE DR STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4526
Practice Address - Country:US
Practice Address - Phone:571-472-4300
Practice Address - Fax:571-665-6771
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187817363LF0000X
VA0001158214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily