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NPI Code Detail

MEDICARE: MRS. TAMI NICOLE VAUGHAN DPH

MEDICARE: MRS. TAMI NICOLE VAUGHAN DPH
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
1183500000XPharmacist12459OK
2183500000XPharmacist38059TX

General Provider Information

NPI Number : 1245312248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAMI NICOLE VAUGHAN DPH
Provider Business Mailing Address
First Line : 2415 MASSACHUSETTS ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66046-4827
Country : US
Telephone Number : 785-832-4891
Fax Number :
Provider Business Practice Location Address
First Line : 2415 MASSACHUSETTS ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66046-4827
Country : US
Telephone Number : 785-832-4891
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2006
Last Update Date : 04/11/2016

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