Healthcare Provider Details

I. General information

NPI: 1912558362
Provider Name (Legal Business Name): ASHLEY VAUGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 RIVER CROSSING PKWY STE 100
INDIANAPOLIS IN
46240-7766
US

IV. Provider business mailing address

333 COMMERCE ST STE 700
NASHVILLE TN
37201-1835
US

V. Phone/Fax

Practice location:
  • Phone: 844-735-3314
  • Fax:
Mailing address:
  • Phone: 615-454-9850
  • Fax: 855-737-5542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71009362A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: