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NPI Code Detail

MEDICARE: REBECCA ERIN VAUGHN NURSE PRACTITIONER

MEDICARE: REBECCA ERIN VAUGHN NURSE PRACTITIONER
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
1163W00000XRegistered NurseRN0000124117TN
2363LF0000XFamily Nurse PractitionerAPN0000013049TN

General Provider Information

NPI Number : 1629110176
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ERIN VAUGHN NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 108 REED MILL LN
Second Line :
City : MONROE
State : TN
Zip : 38573-5613
Country : US
Telephone Number : 931-823-8688
Fax Number :
Provider Business Practice Location Address
First Line : 1120 SAMS ST
Second Line :
City : COOKEVILLE
State : TN
Zip : 38506-4006
Country : US
Telephone Number : 931-528-7312
Fax Number : 931-528-7377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 12/20/2007

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