Provider Demographics
NPI:1164700878
Name:CAUGHEL, KATHERINE CASEY MARTIN (NP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CASEY MARTIN
Last Name:CAUGHEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:CASEY
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1350 MARKET ST FL 1
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-4048
Mailing Address - Country:US
Mailing Address - Phone:781-213-4050
Mailing Address - Fax:
Practice Address - Street 1:HCMC, 701 PARK AVE
Practice Address - Street 2:SURGERY DEPARTMENT, P-5
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR231309-6363LA2100X
MARN2264433363L00000X
IL209011224363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care