Individual
ELLEN VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
610 N. ONE MILE ROAD, DEXTER, MO 63841
(573) 624-3600
Mailing address
10492 STATE HIGHWAY ZZ, DEXTER, MO 63841
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
097001
MO
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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