Individual
TIMOTHY P VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA, APNP
Contact information
Practice address
900 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6122
(715) 717-4121
Mailing address
1436 CLEARWATER RIDGE CT, EAU CLAIRE, WI 54703-3794
(608) 469-4672
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2820-33
WI
367500000X
Certified Registered Nurse Anesthetist
89142030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43309500
—
WI
Enumeration date
11/22/2005
Last updated
03/28/2024
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