Healthcare Provider Details

I. General information

NPI: 1043132673
Provider Name (Legal Business Name): KAELA GOETZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EXEMPLA CIR
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

19726 E BELLEWOOD DR
CENTENNIAL CO
80015-3422
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3382
  • Fax:
Mailing address:
  • Phone: 720-810-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberRTL.0004837
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: