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Individual
JANET A PENNELLA-VAUGHAN
Active
Individual
JANET A PENNELLA-VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F301780
NY
363LF0000X
Family Nurse Practitioner
331701
NY
363LF0000X
Family Nurse Practitioner
Primary
F331701
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01752625
—
NY
01
—
G0189393591
BLUE CHOICE GRP ID
NY
01
—
NP0381
PREFERRED CARE
NY
01
—
P019331701
BLUE CHOICE ID
NY
Enumeration date
08/07/2006
Last updated
07/05/2023
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