Healthcare Provider Details

I. General information

NPI: 1467589473
Provider Name (Legal Business Name): GAYLE M GOOD R.N., B.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

V. Phone/Fax

Practice location:
  • Phone: 720-536-6802
  • Fax:
Mailing address:
  • Phone: 720-536-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number51549
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: