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General NPI Number Information
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NPI Number | 1114085784
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Entity Type | Individual
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Provider Name | KAY LYNN VAUGHN RN, CNS
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 2960 RODEO PARK DR W
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City | SANTA FE
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State | NM
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Zip | 87505-6351
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Country | US
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Telephone | 505-986-9633
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25445
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-0445
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Country | US
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Telephone | 505-767-1193
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Fax | 505-766-6945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 80895
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License Number State | NM
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