Provider Demographics
NPI:1114996378
Name:VAUGHN, STEPHANIE W (FNP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:W
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 GALLATIN RD N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2104
Mailing Address - Country:US
Mailing Address - Phone:615-865-8500
Mailing Address - Fax:615-860-8061
Practice Address - Street 1:1616 GALLATIN RD N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2104
Practice Address - Country:US
Practice Address - Phone:615-865-8500
Practice Address - Fax:615-860-8061
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNS92518Medicare UPIN
TN3904151Medicare PIN
TN3904152Medicare PIN
TN103I507505Medicare PIN
TNI103508874Medicare PIN
TN3904150Medicare PIN
TN103I508043Medicare PIN
TN3904153Medicare PIN