Provider Demographics
NPI:1295705754
Name:COUGHLIN, KATHERINE WIGGINS (CNM)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WIGGINS
Last Name:COUGHLIN
Suffix:
Gender:
Credentials:CNM
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:WIGGINS
Other - Last Name:COUGHLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:1650 COCHRANE CIR BLDG 7500
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4613
Mailing Address - Country:US
Mailing Address - Phone:719-963-8205
Mailing Address - Fax:719-526-7850
Practice Address - Street 1:1650 COCHRANE CIR DEPT OF
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4613
Practice Address - Country:US
Practice Address - Phone:719-526-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO123552367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife