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Individual

ABIGAIL FANTASKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
201 STATE ST, ERIE, PA 16550-0002
(724) 504-2510
Mailing address
2267 PINNACLE CT, ERIE, PA 16506-6449
(724) 504-2510

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
733922
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN733922
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
733922
PA RN LICENSE
PA
Enumeration date
07/29/2024
Last updated
06/06/2025
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