| Doctor Name: | TARA LEAH GOESCH |
| NPI Number: | 1316217946 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 111280 |
| Business Practice Address: | 14080 Hospital Rd Children's Hosp & Medical Ctr - Cardiothoracic Surgery Boys Town, NE - 680107513 |
| Business Phone Number: | 4027786900 |
| Business Fax Number: | 4027786917 |
| Mailing Address: | 555 N 30th St, Children's Hospital & Medical Center OMAHA |
| State: | NE |
| Postal Code: | 681312136 |
| Phone Number: | 4022808100 |
| Fax Number: | 4022808103 |
| NPI Enumeration Date: | 01/12/2012 |
| NPI Last Update Date: | 08/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 111280 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |