MEDICARE: JIL LAYNE VAUGHN SLP

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
1	235Z00000X	Speech-Language Pathologist	12008261	MN

General Provider Information

NPI Number	:	1124965421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIL LAYNE VAUGHN SLP

Provider Business Mailing Address
First Line	:	510 31ST ST
Second Line	:
City	:	HILLS
State	:	MN
Zip	:	56138-4028
Country	:	US
Telephone Number	:	605-759-2421
Fax Number	:

Provider Business Practice Location Address
First Line	:	49 PATRIOT LANE
Second Line	:
City	:	BEAVER CREEK
State	:	MN
Zip	:	56116
Country	:	US
Telephone Number	:	507-673-2541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ JIL LAYNE VAUGHN SLP” Practice Location

Language	Start Address	Practice Location

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