Healthcare Provider Details

I. General information

NPI: 1861072548
Provider Name (Legal Business Name): NATALIE LEE GOULD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 FLORIDA RD UNIT 11
DURANGO CO
81301-4775
US

IV. Provider business mailing address

801 FLORIDA RD UNIT 11
DURANGO CO
81301-4775
US

V. Phone/Fax

Practice location:
  • Phone: 970-782-7540
  • Fax: 970-632-6189
Mailing address:
  • Phone: 970-782-7540
  • Fax: 970-632-6189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberDR.0069465
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDR.0069465
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0069465
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: