Individual
MS. CASSANDRA LEE COGHLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
960 JOHNSON FERRY RD, STE 940, ATLANTA, GA 30342-1631
(404) 851-6000
(404) 252-2736
Mailing address
960 JOHNSON FERRY RD, STE 940, ATLANTA, GA 30342-1631
(404) 851-6000
(404) 252-2736
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006463
GA
363AM0700X
Medical Physician Assistant
Primary
006463
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125044B
—
GA
01
—
1649533035
NPI NUMBER
GA
Enumeration date
06/20/2012
Last updated
02/01/2017
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