Provider Demographics
NPI:1558656884
Name:CAUGHRAN, MARY ELLEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELLEN
Last Name:CAUGHRAN
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:619 19TH ST. SOUTH
Mailing Address - Street 2:MEB 508, UNIVERSITY OF ALABAMA AT BIRMINGHAM HOSPITAL
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-6908
Mailing Address - Country:US
Mailing Address - Phone:205-975-5516
Mailing Address - Fax:205-934-0655
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:MEB 508, UNIVERSITY OF ALABAMA AT BIRMINGHAM HOSPITAL
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-6908
Practice Address - Country:US
Practice Address - Phone:205-975-5516
Practice Address - Fax:205-934-0655
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-070978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily