Healthcare Provider Details

I. General information

NPI: 1063790871
Provider Name (Legal Business Name): ELISE J. TALLANT NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PRAIRIE CENTER PKWY
BRIGHTON CO
80601-4006
US

IV. Provider business mailing address

1600 PRAIRIE CENTER PKWY
BRIGHTON CO
80601-4006
US

V. Phone/Fax

Practice location:
  • Phone: 303-498-3547
  • Fax:
Mailing address:
  • Phone: 303-498-3547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number173920
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: