Healthcare Provider Details

I. General information

NPI: 1851933675
Provider Name (Legal Business Name): CHRISTINA VAUGHANS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA EATMON CRNP

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28779 NICK DAVIS RD
HARVEST AL
35749-7009
US

IV. Provider business mailing address

28779 NICK DAVIS RD
HARVEST AL
35749-7009
US

V. Phone/Fax

Practice location:
  • Phone: 256-233-4600
  • Fax:
Mailing address:
  • Phone: 256-233-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-158063
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number16321
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1158063
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71016709A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11545
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: