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NPI Code Detail

MEDICARE: VALERIE VAUGHN RN, MSN, APRN, CNM

MEDICARE: VALERIE VAUGHN RN, MSN, APRN, CNM
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
1367A00000XAdvanced Practice Midwife1022181TX

General Provider Information

NPI Number : 1972199750
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE VAUGHN RN, MSN, APRN, CNM
Provider Business Mailing Address
First Line : 119 DERBY LN
Second Line :
City : HICKORY CREEK
State : TX
Zip : 75065-0347
Country : US
Telephone Number : 214-440-9903
Fax Number :
Provider Business Practice Location Address
First Line : 622 HEMPHILL ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3179
Country : US
Telephone Number : 817-878-2737
Fax Number : 817-878-2735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2020
Last Update Date : 12/16/2020

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