Healthcare Provider Details

I. General information

NPI: 1578480661
Provider Name (Legal Business Name): GWENDOLEN HOPE VAUGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39245 MCGRATH RD
POMEROY OH
45769-9523
US

IV. Provider business mailing address

39245 MCGRATH RD
POMEROY OH
45769-9523
US

V. Phone/Fax

Practice location:
  • Phone: 740-444-9222
  • Fax:
Mailing address:
  • Phone: 740-444-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: