Individual
LYNN A VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
920 6TH AVE, LEAVENWORTH, KS 66048-3225
(913) 682-8900
Mailing address
989 PEBBLE BEACH DR, LANSING, KS 66043-1232
(913) 727-2874
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
27598
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300427
UNITED HEALTHCARE
KS
01
—
102093
BLUE CROSS BLUE SHIELD KS
KS
01
—
27598
STATE LICENSE
KS
01
—
30809019
BCBS OF KANSAS CITY
KS
01
—
4027819
AETNA PROVIDER #
KS
Enumeration date
02/13/2007
Last updated
07/08/2007
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