Healthcare Provider Details

I. General information

NPI: 1134855703
Provider Name (Legal Business Name): EMILY VAUGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N FL 3507TH
NAPLES FL
34102-5754
US

IV. Provider business mailing address

240 QUAIL FOREST BLVD APT 214
NAPLES FL
34105-5518
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-5000
  • Fax:
Mailing address:
  • Phone: 443-309-9720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11024002
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9546826
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: