Individual
LACIA VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14 BRANCH PL, ROOSEVELT, NY 11575-1505
(917) 561-6552
Mailing address
14 BRANCH PL, ROOSEVELT, NY 11575-1505
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2311082
NY
Other
Enumeration date
12/23/2025
Last updated
12/23/2025
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