Provider Demographics
NPI:1407942956
Name:VAUGHN, RAYELLA JO (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:RAYELLA
Middle Name:JO
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 610
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556
Mailing Address - Country:US
Mailing Address - Phone:931-879-8133
Mailing Address - Fax:931-879-9365
Practice Address - Street 1:346 WEST CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556
Practice Address - Country:US
Practice Address - Phone:931-879-8133
Practice Address - Fax:931-879-9365
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist