Individual
REBECCA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2730 CHANNING WAY, IDAHO FALLS, ID 83404-7509
(208) 542-7100
Mailing address
359 N 3RD W APT 303, RIGBY, ID 83442-1146
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9671543
ID
Other
Enumeration date
01/31/2025
Last updated
02/12/2025
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