Organization
EMPOWERED PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRICA VAUGHAN CPNP (PEDIATRIC NURSE PRACTITIONER)
(262) 307-1319
Entity
Organization
Contact information
Practice address
W229N1433 WESTWOOD DR STE 104, WAUKESHA, WI 53186-1172
(262) 307-1319
(855) 857-9099
Mailing address
W229N1433 WESTWOOD DR STE 104, WAUKESHA, WI 53186-1172
(262) 307-1319
(855) 857-9099
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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