Individual
KEVIN B VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-8000
Mailing address
1316 OLD 63 S, SUITE 102, COLUMBIA, MO 65201-6092
(573) 875-8838
(573) 875-8589
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
141056
MO
Other
Enumeration date
12/07/2006
Last updated
07/08/2007
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