Individual
AMANDA NICOLE VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNAP CRNA
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-5432
Mailing address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-5432
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
116903
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2022
Last updated
08/10/2023
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