Individual
BRIDGETTE L VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
413 CHURCH ST, CAHOKIA, IL 62206-1821
(618) 304-2333
Mailing address
413 CHURCH ST, CAHOKIA, IL 62206-1821
(618) 304-2333
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209021052
IL
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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