Provider Demographics
NPI:1982124673
Name:ABRAMS, ELIZABETH PIERCE (RD, CSP, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:PIERCE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:RD, CSP, IBCLC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:PIERCE
Other - Last Name:BUSTAMANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CSP
Mailing Address - Street 1:6591 N POSITANO WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3038
Mailing Address - Country:US
Mailing Address - Phone:520-609-7006
Mailing Address - Fax:
Practice Address - Street 1:3844 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3308
Practice Address - Country:US
Practice Address - Phone:520-477-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133VN1004X
AZL-124887174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric