Provider Demographics
NPI:1598230328
Name:GILLESPIE, ELIZABETH JASON (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JASON
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:JANE
Other - Last Name:JASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5200 DTC PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2719
Mailing Address - Country:US
Mailing Address - Phone:303-745-0000
Mailing Address - Fax:303-773-3101
Practice Address - Street 1:5200 DTC PKWY STE 400
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2719
Practice Address - Country:US
Practice Address - Phone:303-745-0000
Practice Address - Fax:303-773-3101
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994205-NP363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0994205-NPOtherCO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS AND OCCUPATIONS