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General NPI Number Information
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NPI Number | 1689492357
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Entity Type | Individual
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Provider Name | CIERRA MONET COUGHLIN NP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 6000 EXECUTIVE BLVD STE 101
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City | ROCKVILLE
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State | MD
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Zip | 20852-3816
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Country | US
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Telephone | 240-599-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 437 NEW YORK AVE NW APT 701
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City | WASHINGTON
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State | DC
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Zip | 20001-4752
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Country | US
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Telephone | 202-255-5529
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R268206
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License Number State | MD
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