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Individual

TRACY D VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1001 BLYTHE BLVD, MEDICAL CENTER PLAZA, SUITE 200, CHARLOTTE, NC 28203-5866
(704) 381-8840
(704) 381-8848
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 381-8840
(704) 381-8848

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
208003
NC
363LN0000X
Neonatal Nurse Practitioner
Primary
5001106
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801037023
NC
05
NP3292
SC
Enumeration date
03/18/2009
Last updated
05/04/2023
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