Provider Demographics
NPI:1760370910
Name:VAUGHN, GEORGIA OAKLEY (RD, LDN)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:OAKLEY
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 N CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-8317
Mailing Address - Country:US
Mailing Address - Phone:919-717-0532
Mailing Address - Fax:
Practice Address - Street 1:3116 N DUKE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2102
Practice Address - Country:US
Practice Address - Phone:919-620-5356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL008670133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered