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General NPI Number Information
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NPI Number | 1881778116
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Entity Type | Individual
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Provider Name | MELISSA LEIGH VAUGHN
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | COMDT CG-1122 U S C G 2100 2ND ST SW
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City | WASHINGTON
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State | DC
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Zip | 20593-0001
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Country | US
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Telephone | 907-966-5463
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Fax |
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Provider Business Mailing Address
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Address Line | 104 PATTERSON WAY #B
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City | SITKA
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State | AK
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Zip | 99835-9513
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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