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General NPI Number Information
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NPI Number | 1497164446
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Entity Type | Individual
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Provider Name | MARY VAUGHN DNP, FNP-C, PMHNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2014
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 3600 BLUECUTT RD STE 201
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City | COLUMBUS
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State | MS
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Zip | 39705-1397
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Country | US
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Telephone | 662-329-3973
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Fax | 662-329-9056
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Provider Business Mailing Address
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Address Line | 3600 BLUECUTT RD STE 103
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City | COLUMBUS
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State | MS
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Zip | 39705-1397
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Country | US
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Telephone |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APN.0996054-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F0614908
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024043303
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License Number State | MS
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