Provider Demographics
NPI:1992427439
Name:BORNO, ELISABETH GESSIE
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:GESSIE
Last Name:BORNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 PROVIDENCE ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6254
Mailing Address - Country:US
Mailing Address - Phone:401-602-9626
Mailing Address - Fax:401-291-5710
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:OFFICE #3
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:401-602-9226
Practice Address - Fax:401-291-5710
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI04087363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health