Basic Information
Provider Information
NPI: 1225187701
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABSHER
FirstName: ELIZABETH
MiddleName: MAY
NamePrefix: MRS.
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 402 HIGHLAND TRL
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275168628
CountryCode: US
TelephoneNumber: 9199683456
FaxNumber: 9199323456
Practice Location
Address1: 1829 E FRANKLIN ST
Address2: BLDG. #600
City: CHAPEL HILL
State: NC
PostalCode: 275145861
CountryCode: US
TelephoneNumber: 9199683456
FaxNumber: 9199323456
Other Information
ProviderEnumerationDate: 01/10/2007
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X3836NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

ID Information
IDTypeStateIssuerDescription
1392G01NCO.T.OTHER
730183105NC MEDICAID


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