Provider Demographics
NPI:1184069163
Name:VAUGHAN, CAROL ANN
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:VAUGHAN
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 1:605 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4901
Mailing Address - Country:US
Mailing Address - Phone:843-849-2826
Mailing Address - Fax:843-849-2897
Practice Address - Street 1:605 CENTER ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4901
Practice Address - Country:US
Practice Address - Phone:843-849-2826
Practice Address - Fax:843-849-2897
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN.16608R163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse