Provider Demographics
NPI:1083503452
Name:GALLANT, ELIZABETH (RN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:GALLANT
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:FAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7230 ARBUCKLE CMNS STE 262
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-1798
Mailing Address - Country:US
Mailing Address - Phone:317-207-0272
Mailing Address - Fax:
Practice Address - Street 1:7230 ARBUCKLE CMNS STE 262
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1798
Practice Address - Country:US
Practice Address - Phone:317-207-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28184211A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health