Provider Demographics
NPI:1659129831
Name:KNIPPLE, VAUGHN M (MSN)
Entity type:Individual
Prefix:
First Name:VAUGHN
Middle Name:M
Last Name:KNIPPLE
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PARK CT
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2086
Mailing Address - Country:US
Mailing Address - Phone:609-780-2576
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 863
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08625-0863
Practice Address - Country:US
Practice Address - Phone:856-785-0040
Practice Address - Fax:856-785-2382
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12718000163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development