Provider Demographics
NPI:1912562653
Name:VAUGHN, MICHLYN DIANE
Entity Type:Individual
Prefix:
First Name:MICHLYN
Middle Name:DIANE
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:PO BOX 2701
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8175
Mailing Address - Country:US
Mailing Address - Phone:469-500-3871
Mailing Address - Fax:
Practice Address - Street 1:1920 GRASSMERE LN APT 516
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-8529
Practice Address - Country:US
Practice Address - Phone:469-500-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313811164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse