Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 16296 | TN |
NPI | 1083981815 |
---|---|
Provider Name | Jordan Vaughan |
First Address | Nashville, TN 37203-6514 |
Second Address | Nashville, TN 37203-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2011 |
Last Update Date | 07/01/2022 |