Individual
MARTIN W COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
393 DUNLAP ST, ST PAUL, MN 55104
(651) 602-7245
Mailing address
2854 HIGHWAY 55, SUITE 130, EAGAN, MN 55121
(651) 224-4930
(651) 842-3391
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0887281
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
936343200
—
MN
Enumeration date
02/14/2006
Last updated
08/31/2012
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