Individual
ROLANDINE VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1862 AUBURN RD STE 118-X1, DACULA, GA 30019-1676
(404) 906-6985
(678) 302-7377
Mailing address
2084 MITFORD CT, DACULA, GA 30019-2486
(678) 960-8953
(678) 302-7377
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
005982
GA
363A00000X
Physician Assistant
005982
GA
363A00000X
Physician Assistant
0110002860
VA
363A00000X
Physician Assistant
Primary
10004230A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00429217D
—
GA
Enumeration date
08/08/2008
Last updated
03/15/2024
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