Healthcare Provider Details

I. General information

NPI: 1245623727
Provider Name (Legal Business Name): LINDSAY DANIELLE GOSS NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD # MS 31
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

3100 RIVERSIDE DR APT 213
LOS ANGELES CA
90027-1481
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-9312
  • Fax:
Mailing address:
  • Phone: 702-366-3342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number23852
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: