Provider Demographics
NPI:1619690781
Name:VAUGHN, KAREN DENISE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DENISE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1647 S ELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4207
Mailing Address - Country:US
Mailing Address - Phone:918-585-1389
Mailing Address - Fax:918-585-1389
Practice Address - Street 1:1466 E PERKINS AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-3226
Practice Address - Country:US
Practice Address - Phone:918-500-1048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist