Provider Demographics
NPI:1134540149
Name:GOOD, ELLIOT (DNP)
Entity type:Individual
Prefix:
First Name:ELLIOT
Middle Name:
Last Name:GOOD
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6897 PAIUTE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7169
Mailing Address - Country:US
Mailing Address - Phone:303-652-4196
Mailing Address - Fax:303-652-4007
Practice Address - Street 1:6897 PAIUTE AVE
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-7182
Practice Address - Country:US
Practice Address - Phone:303-652-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN0186551163W00000X
COAPN.0991082-NP363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily