Individual
KEVIN ANTHONY VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1130 S HANOVER ST STE 3, BALTIMORE, MD 21230-3718
(410) 387-6576
Mailing address
1130 S HANOVER ST STE 3, BALTIMORE, MD 21230-3718
(410) 387-6576
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225580269
—
MD
Enumeration date
10/25/2016
Last updated
08/08/2019
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