MEDICARE: MISS LINDSAY JANE GOSS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	181342	CO

General Provider Information

NPI Number	:	1568611168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LINDSAY JANE GOSS RN

Provider Business Mailing Address
First Line	:	DEPT 1057
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80291-0001
Country	:	US
Telephone Number	:	303-486-5500
Fax Number	:	303-486-5502

Provider Business Practice Location Address
First Line	:	4200 W CONEJOS PL
Second Line	:	SUITE 516
City	:	DENVER
State	:	CO
Zip	:	80204-1333
Country	:	US
Telephone Number	:	303-629-3815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	11/13/2008

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