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Individual
ROLANDINE VAUGHAN
Active
Individual
ROLANDINE VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
005982
GA
363A00000X
Physician Assistant
005982
GA
363A00000X
Physician Assistant
0110002860
VA
363A00000X
Physician Assistant
Primary
10004230A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00429217D
—
GA
Enumeration date
08/08/2008
Last updated
03/15/2024
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