Provider Demographics
NPI:1831238716
Name:VAUGHAN, BETTY CAROL (RN)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:CAROL
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 GRANTHAM WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2373
Mailing Address - Country:US
Mailing Address - Phone:859-263-0087
Mailing Address - Fax:
Practice Address - Street 1:650 NEWTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1113
Practice Address - Country:US
Practice Address - Phone:859-252-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1022956163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool