Provider Demographics
NPI:1366628778
Name:TAYLOR-VAUGHAN, LEE ADAM (RN, MSN, APRN,BC)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ADAM
Last Name:TAYLOR-VAUGHAN
Suffix:
Gender:M
Credentials:RN, MSN, APRN,BC
Other - Prefix:
Other - First Name:ADAM
Other - Middle Name:LEE
Other - Last Name:TAYLOR-VAUGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, APRN,BC
Mailing Address - Street 1:4814 BLOOMINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5564
Mailing Address - Country:US
Mailing Address - Phone:973-641-8488
Mailing Address - Fax:732-301-2864
Practice Address - Street 1:1 RWJ PL
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1928
Practice Address - Country:US
Practice Address - Phone:732-828-3000
Practice Address - Fax:732-301-2864
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00137300363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care