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Individual

MRS. LOLITA MARIA VAUGHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
9501 ROOSEVELT AVE., SUITE 404, PHILADELPHIA, PA 19114
(215) 676-6696
(215) 676-6697
Mailing address
9501 ROOSEVELT BLVD., SUITE 404, PHILADELPHIA, PA 19114
(215) 676-6696
(215) 676-6697

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
UP004943G
PA

Other

Enumeration date
03/06/2012
Last updated
03/06/2012
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