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Individual

JENNIFER VAUGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
300 W ESPLANADE AVE, KENNER, LA 70065-2540
(504) 464-4153
(504) 464-9949
Mailing address
300 W ESPLANADE AVE, KENNER, LA 70065-2540
(504) 464-4153
(504) 464-9949

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1376-508T
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1099155
LA
Enumeration date
10/04/2006
Last updated
10/14/2008
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