Provider Demographics
NPI:1588420962
Name:VAUGHAN, RANDI C (FNP-C)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:C
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 MEADOWLARK LN STE 205
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1200
Mailing Address - Country:US
Mailing Address - Phone:833-354-1492
Mailing Address - Fax:
Practice Address - Street 1:1333 MEADOWLARK LN STE 205
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1200
Practice Address - Country:US
Practice Address - Phone:833-354-1492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82929-081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily