Provider Demographics
NPI:1427183334
Name:VAUGHN, GINA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 MEDICAL BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1354
Mailing Address - Country:US
Mailing Address - Phone:419-889-8612
Mailing Address - Fax:419-423-7665
Practice Address - Street 1:1721 MEDICAL BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1354
Practice Address - Country:US
Practice Address - Phone:419-423-7663
Practice Address - Fax:419-423-7665
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09315363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2736169Medicaid
OH2736169Medicaid
OHQ76280Medicare UPIN