Provider Demographics
NPI:1659762052
Name:COUGHLIN, ERIN (NP-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 AULIKE STREET SUITE #405
Mailing Address - Street 2:KAILUA PROFESSIONAL CENTER 1
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734
Mailing Address - Country:US
Mailing Address - Phone:808-263-7340
Mailing Address - Fax:808-263-7339
Practice Address - Street 1:30 AULIKE STREET SUITE #405
Practice Address - Street 2:KAILUA PROFESSIONAL CENTER 1
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-263-7340
Practice Address - Fax:808-263-7339
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily