Provider Demographics
NPI:1083981815
Name:VAUGHAN, JORDAN (APN)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 23RD AVE N STE 250
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6514
Mailing Address - Country:US
Mailing Address - Phone:615-342-6880
Mailing Address - Fax:615-986-5960
Practice Address - Street 1:345 24TH AVE N
Practice Address - Street 2:SUITE 401
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1507
Practice Address - Country:US
Practice Address - Phone:615-321-4740
Practice Address - Fax:615-320-0240
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16296363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health