Individual
KATHRYN A COUGHLIN-KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3165
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-3165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37812
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8948206
—
NC
Enumeration date
03/06/2007
Last updated
07/08/2007
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