Provider Demographics
NPI:1669196408
Name:COOGAN, CAITLIN JOANNE (RN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:JOANNE
Last Name:COOGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 QUALITY CIR NW APT 635
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4578
Mailing Address - Country:US
Mailing Address - Phone:303-518-3125
Mailing Address - Fax:
Practice Address - Street 1:201 QUALITY CIR NW APT 635
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4578
Practice Address - Country:US
Practice Address - Phone:303-518-3125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-180578163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient