Individual
VALENCIA L VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5846 RIDGEWOOD RD STE C101, JACKSON, MS 39211-2646
(601) 213-8441
Mailing address
5846 RIDGEWOOD RD STE C101, JACKSON, MS 39211-2646
(601) 213-8441
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A060372
MS
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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