Healthcare Provider Details

I. General information

NPI: 1992944896
Provider Name (Legal Business Name): VAUGHN PAUL JONES CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 E 280 N
ST GEORGE UT
84790-2400
US

IV. Provider business mailing address

1791 E 280 N
ST GEORGE UT
84790-2400
US

V. Phone/Fax

Practice location:
  • Phone: 435-656-2020
  • Fax:
Mailing address:
  • Phone: 435-656-2020
  • Fax: 435-634-2646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number13976
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number356745
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: