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General NPI Number Information
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NPI Number | 1447787676
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Entity Type | Organization
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Legal Business Name | JENNA VAUGHT LLC
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 801 E BRANNON RD UNIT 322
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-6095
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Country | US
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Telephone | 502-438-7739
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 910216
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City | LEXINGTON
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State | KY
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Zip | 40591-0216
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Country | US
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Telephone | 502-438-7739
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Fax |
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Authorized Official
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Title or Position | OWNER OF PRIVATE PRACTICE
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Name | DR. JENNA BETH VAUGHT
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Credential | DPM
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Telephone | 502-438-7739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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