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General NPI Number Information
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NPI Number | 1740349026
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Entity Type | Organization
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Legal Business Name | DENISE VAUGHT
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 786 MURRAY RD
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City | KINGSTON
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State | NY
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Zip | 12401-7144
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Country | US
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Telephone | 845-336-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 786 MURRAY RD
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City | KINGSTON
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State | NY
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Zip | 12401-7144
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Country | US
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Telephone | 845-336-7337
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DENISE ANNE VAUGHT
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Credential |
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Telephone | 845-336-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 1530231
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License Number State | NY
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