Provider Demographics
NPI:1023804945
Name:JENNA B VAUGHT LLC
Entity type:Organization
Organization Name:JENNA B VAUGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:VAUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:502-438-7739
Mailing Address - Street 1:PO BOX 910216
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0216
Mailing Address - Country:US
Mailing Address - Phone:502-438-7739
Mailing Address - Fax:
Practice Address - Street 1:801 E BRANNON RD UNIT 322
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-6095
Practice Address - Country:US
Practice Address - Phone:502-438-7739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty