| Doctor Name: | MRS. LISA DEVINE COUGHLIN |
| NPI Number: | 1487090627 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 264995 |
| Business Practice Address: | 200 West Hospital Dr Whiteriver, AZ - 859410860 |
| Business Phone Number: | 9283383532 |
| Business Fax Number: | |
| Mailing Address: | 200 West Hospital Drive, WHITERIVER |
| State: | AZ |
| Postal Code: | 859410860 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2013 |
| NPI Last Update Date: | 03/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 264995 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |