Provider Demographics
NPI:1235743386
Name:COUGHLIN, NICOLE M (DOULA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 INDIAN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-3916
Mailing Address - Country:US
Mailing Address - Phone:620-314-9935
Mailing Address - Fax:
Practice Address - Street 1:2059 INDIAN HILLS DR
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-3916
Practice Address - Country:US
Practice Address - Phone:620-314-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-06
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula