Individual
MRS. SHANNON WADE VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN-BSN, CHPN
Contact information
Practice address
210 W MAIN ST, UNION, SC 29379-2215
(864) 429-1692
Mailing address
210 W MAIN ST, UNION, SC 29379-2215
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200138
SC
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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