Provider Demographics
NPI:1114729415
Name:COUGHLIN, KATHERINE (RN, BSN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:COUGHLIN
Suffix:
Gender:
Credentials:RN, BSN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:KRUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:2281 AKERS MILL RD SE APT 4825
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2687
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2281 AKERS MILL RD SE APT 4825
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2687
Practice Address - Country:US
Practice Address - Phone:706-627-6307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN314236163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse