Vaughan, Jerrica Brianne

Vaughan, Jerrica Brianne is an individual health care provider with primary practice located at 4855 S Moorland Rd Ste 250 , New Berlin WI 53151-7494. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics is her primary health care specialty. Vaughan, Jerrica Brianne can be contacted via phone (262) 789-6020.

Contact Information

Primary practice address
4855 S Moorland Rd Ste 250 New Berlin WI 53151-7494
Phone: (262) 789-6020
Fax: (262) 789-6025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 20227463 Wisconsin
Nursing Service Providers / Registered Nurse 163W00000X 226174 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 7420 Wisconsin

Profile Details

NPI number 1245768662
LBN Legal business name Vaughan, Jerrica Brianne
Credentials CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2017
Last updated Jul 10th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245768662 NPPES
Wisconsin MEDICAID 1245768662

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