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General NPI Number Information
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NPI Number | 1255972352
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Entity Type | Individual
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Provider Name | KIMBERLY KAY YAUGHN PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 606 BRANNEN ST STE B
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City | STATESBORO
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State | GA
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Zip | 30458-5184
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Country | US
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Telephone | 912-225-9279
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Fax | 912-225-9284
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Provider Business Mailing Address
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Address Line | 2505 WATERINGHOLE CT
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City | STATESBORO
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State | GA
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Zip | 30458-8671
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Country | US
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Telephone | 912-536-1137
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH020447
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License Number State | GA
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