Provider Demographics
NPI:1043601669
Name:VAUGHN, RHONDA (CPTA)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-4841
Mailing Address - Country:US
Mailing Address - Phone:913-991-8355
Mailing Address - Fax:
Practice Address - Street 1:757 EISENHOWER RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043
Practice Address - Country:US
Practice Address - Phone:913-991-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01163225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant