Vaughan, Keely E

Vaughan, Keely E is an individual health care provider with primary practice located at 117 Kennedy Dr , Martin TN 38237-3394. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Vaughan, Keely E can be contacted via phone (731) 587-9511.

Contact Information

Primary practice address
117 Kennedy Dr Martin TN 38237-3394
Phone: (731) 587-9511
Fax: (877) 309-6416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2812 Tennessee

Profile Details

NPI number 1780060319
LBN Legal business name Vaughan, Keely E
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2015
Last updated May 26th, 2021 - about 4 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 1780060319 NPPES
Tennessee MEDICAID Q018026
Tennessee Other 5440149
Tennessee Other 2153951
Tennessee Other 3815442
Tennessee Other P01577761

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