Provider Demographics
NPI:1053681213
Name:VAUGHN, JOYCE CHAPPELL (APMHNP)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:CHAPPELL
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:APMHNP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:CHAPPELL
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN APMHNP
Mailing Address - Street 1:220 HIGHWAY 12 W
Mailing Address - Street 2:P.O. BOX 887
Mailing Address - City:KOSCIUSKO
Mailing Address - State:MS
Mailing Address - Zip Code:39090-3208
Mailing Address - Country:US
Mailing Address - Phone:662-290-3134
Mailing Address - Fax:662-290-3337
Practice Address - Street 1:3531 LAKELAND DR
Practice Address - Street 2:SUITE 1058
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8049
Practice Address - Country:US
Practice Address - Phone:601-420-5810
Practice Address - Fax:601-420-5811
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR144380363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health