Individual
TIFFANY RENEE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6138 W 30TH ST, INDIANAPOLIS, IN 46224-3055
(317) 603-9101
Mailing address
6138 W 30TH ST, INDIANAPOLIS, IN 46224-3055
(317) 603-9101
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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