Provider Demographics
NPI:1124641121
Name:VAUGHT, NETA
Entity type:Individual
Prefix:
First Name:NETA
Middle Name:
Last Name:VAUGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 13TH ST SE # 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4533
Mailing Address - Country:US
Mailing Address - Phone:202-704-7825
Mailing Address - Fax:
Practice Address - Street 1:3323 13TH ST SE # 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4533
Practice Address - Country:US
Practice Address - Phone:202-704-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant