Individual
ANITA L. VAUGHN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1451 ROBERTS RD, MEMPHIS, TN 38106-6938
(901) 406-3759
Mailing address
1451 ROBERTS RD, MEMPHIS, TN 38106-6938
(901) 406-3759
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172A00000
—
TN
Enumeration date
02/17/2021
Last updated
06/03/2021
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