Lorraine P Vaughan
Nurse Practitioner, Family in Amityville, NY. Individual provider (NPI-1).
NPI number1265645865
StatusActive
Last updated in NPPESJan 3, 2021
Details
- NPI
- 1265645865
- Entity type
- Individual (NPI-1)
- Name
- Lorraine P Vaughan
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 8, 2007
- Certification date
- Jan 3, 2021
- Last updated
- Jan 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F346635 | NY | Yes |
| 163W00000X | Registered Nurse | 620739 | NY | |
| 174400000X | Specialist | 28VA1051478 | NY |
Practice location
15 Harrison Ave Apt 23cAmityville, NY 11701-2431
Phone 631-789-6552
Mailing address
15 Harrison Ave Apt 23cAmityville, NY 11701-2431
Phone 631-789-6552
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