Healthcare Provider Details

I. General information

NPI: 1447602321
Provider Name (Legal Business Name): EMILEE GAYLE VAUGHT DNP, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W MAIN ST
HORATIO AR
71842-0308
US

IV. Provider business mailing address

206 W MAIN ST PO BOX 308
HORATIO AR
71842-0308
US

V. Phone/Fax

Practice location:
  • Phone: 870-832-5848
  • Fax: 870-832-0206
Mailing address:
  • Phone: 870-832-5848
  • Fax: 870-832-0206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA004814
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: