Healthcare Provider Details

I. General information

NPI: 1699687020
Provider Name (Legal Business Name): CLAIRE GOSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 CLOVER LN
FORT COLLINS CO
80521-1632
US

IV. Provider business mailing address

229 CLOVER LN
FORT COLLINS CO
80521-1632
US

V. Phone/Fax

Practice location:
  • Phone: 208-358-2946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN.1677094
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: