Individual
MRS. KRYSTAL HENLEY VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
121 W MACCLENNY AVE, MACCLENNY, FL 32063-2029
(904) 259-6380
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5013268
NC
363L00000X
Nurse Practitioner
Primary
APRN11032830
FL
363LF0000X
Family Nurse Practitioner
5013268
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123230500
—
FL
Enumeration date
07/09/2020
Last updated
04/29/2026
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