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General NPI Number Information
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NPI Number | 1508740572
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Entity Type | Individual
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Provider Name | CIARA JADE VAUGHN CSFA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 245 FLOYD DR
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City | ATHENS
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State | GA
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Zip | 30607-1469
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Country | US
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Telephone | 762-356-4780
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Fax | 706-608-7597
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Provider Business Mailing Address
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Address Line | 3009 HUDSON RIVERS CHURCH RD
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City | DANIELSVILLE
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State | GA
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Zip | 30633-2015
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Country | US
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Telephone | 706-983-2273
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 201508
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License Number State | GA
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