Provider Demographics
NPI:1063793784
Name:VAUGHAN, ERIN ANN (ARNP)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:ANN
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6428 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2813
Mailing Address - Country:US
Mailing Address - Phone:904-724-1717
Mailing Address - Fax:904-724-1719
Practice Address - Street 1:6428 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2813
Practice Address - Country:US
Practice Address - Phone:904-724-1717
Practice Address - Fax:904-724-1719
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9238697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily