Provider Demographics
NPI:1932745528
Name:VAUGHN, GRACE (DNP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 NATCHEZ ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1806
Mailing Address - Country:US
Mailing Address - Phone:717-609-7672
Mailing Address - Fax:
Practice Address - Street 1:446 NATCHEZ ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211-1806
Practice Address - Country:US
Practice Address - Phone:717-609-7672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN683265163WC0200X
PA136214367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine