Doctor Name: | MRS. KATHY LEIGH VAUGHN |
NPI Number: | 1265662183 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-094408 |
Business Practice Address: | 1180 Sardis Dr Boaz, AL - 359562139 |
Business Phone Number: | 2565939999 |
Business Fax Number: | 2565939141 |
Mailing Address: | Po Box 1049, BOAZ |
State: | AL |
Postal Code: | 359572201 |
Phone Number: | 2565939999 |
Fax Number: | 2565939141 |
NPI Enumeration Date: | 07/27/2009 |
NPI Last Update Date: | 07/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-094408 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |