Provider Demographics
NPI:1669007035
Name:VAUGHN, ANGELI LUCHE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELI
Middle Name:LUCHE
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 FRANKLIN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7486
Mailing Address - Country:US
Mailing Address - Phone:915-667-2589
Mailing Address - Fax:
Practice Address - Street 1:10201 GATEWAY BLVD W STE 210
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7647
Practice Address - Country:US
Practice Address - Phone:915-591-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145440363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care