Provider Demographics
NPI:1457766693
Name:VAUGHN, RASHELLE
Entity Type:Individual
Prefix:
First Name:RASHELLE
Middle Name:
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 1:54814 COUNTY ROAD 504
Mailing Address - Street 2:
Mailing Address - City:ROSE
Mailing Address - State:OK
Mailing Address - Zip Code:74364-1325
Mailing Address - Country:US
Mailing Address - Phone:918-798-0163
Mailing Address - Fax:
Practice Address - Street 1:54814 COUNTY ROAD 504
Practice Address - Street 2:
Practice Address - City:ROSE
Practice Address - State:OK
Practice Address - Zip Code:74364-1325
Practice Address - Country:US
Practice Address - Phone:918-798-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator