Dominique Nicole Vaughn, AGNP-C
Nurse Practitioner, Gerontology in Cordova, TN. Individual provider (NPI-1).
NPI number1124884895
StatusActive
Last updated in NPPESMay 12, 2025
Details
- NPI
- 1124884895
- Entity type
- Individual (NPI-1)
- Name
- Dominique Nicole Vaughn
- Credential
- AGNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2024
- Certification date
- May 12, 2025
- Last updated
- May 12, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 35863 | TN | Yes |
Practice location
682 Woodland Fox Ln WCordova, TN 38018-1147
Phone 901-436-0542
Mailing address
682 Woodland Fox Ln WCordova, TN 38018-1147
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Gerontology Nurse Practitioner providers in Cordova, TN
- Lisa Michelle Archer, RN, APRNNPI 1821732488
- Cvelyn Love, AGACNP-BCNPI 1285429647
- Pamala Terry, AGNP-CNPI 1043048200
- Dawn Fay ThorntonNPI 1295664738
All 5 Gerontology Nurse Practitioner providers in Cordova · All 1,789 providers in Cordova
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