Individual
KEELY E VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
117 KENNEDY DR, MARTIN, TN 38237-3394
(731) 587-9511
(877) 309-6416
Mailing address
117 KENNEDY DR, MARTIN, TN 38237-3309
(731) 587-9511
(877) 309-6416
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2812
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153951
CIGNA
—
01
—
3815442
AMERIGROUP
—
01
—
5440149
BCBS
—
01
—
P01577761
RAIL ROAD MEDICARE
—
05
—
Q018026
—
TN
Enumeration date
08/05/2015
Last updated
05/26/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us