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NPI Code Detail

MEDICARE: TIFFANY L VAUGHT FNP

MEDICARE: TIFFANY L VAUGHT FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner663890TX

General Provider Information

NPI Number : 1023444163
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY L VAUGHT FNP
Provider Business Mailing Address
First Line : 605 E 4TH ST STE 203
Second Line :
City : ODESSA
State : TX
Zip : 79761-5100
Country : US
Telephone Number : 432-617-8329
Fax Number :
Provider Business Practice Location Address
First Line : 605 E 4TH ST STE 203
Second Line :
City : ODESSA
State : TX
Zip : 79761-5100
Country : US
Telephone Number : 432-617-8329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2013
Last Update Date : 12/01/2025

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Directions to “ TIFFANY L VAUGHT FNP” Practice Location

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