Individual
VANESSA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
2526 OAK CIR, ELLENWOOD, GA 30294-3427
(251) 447-3548
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-152562
AL
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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