Provider Demographics
NPI:1356056576
Name:GOFF, ERIN COLETTE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:COLETTE
Last Name:GOFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26981 RUHL RD
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723-1320
Mailing Address - Country:US
Mailing Address - Phone:970-380-8565
Mailing Address - Fax:
Practice Address - Street 1:122 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-1702
Practice Address - Country:US
Practice Address - Phone:970-842-2861
Practice Address - Fax:865-560-7110
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998216-NP363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner