Individual
JAVAN BOZARD VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
3 RICHLAND MEDICAL PARK DR STE 120, COLUMBIA, SC 29203-6850
(803) 434-8866
(803) 933-3049
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6294
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23149
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23149
SC BOARD OF NURSING
SC
Enumeration date
09/17/2019
Last updated
03/26/2024
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