Provider Demographics
NPI:1225416647
Name:VAUGHN, LAURA (IOMT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:IOMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-0187
Mailing Address - Country:US
Mailing Address - Phone:225-239-2301
Mailing Address - Fax:
Practice Address - Street 1:317 SMITH REED RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2605
Practice Address - Country:US
Practice Address - Phone:225-239-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other