1104256031 NPI number — MRS. CAROLINE FOSTER VAUGHN N.P.

Table of content: MRS. CAROLINE FOSTER VAUGHN N.P. (NPI 1104256031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104256031 NPI number — MRS. CAROLINE FOSTER VAUGHN N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAUGHN
Provider First Name:
CAROLINE
Provider Middle Name:
FOSTER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOSTER
Provider Other First Name:
FRANCES
Provider Other Middle Name:
CAROLINE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
N.P.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1104256031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 19TH STREET
Provider Second Line Business Mailing Address:
SUITE 509
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37916-1853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-524-3208
Provider Business Mailing Address Fax Number:
865-524-9401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 19TH STREET
Provider Second Line Business Practice Location Address:
SUITE 509
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37916-1853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-524-3208
Provider Business Practice Location Address Fax Number:
865-524-9401
Provider Enumeration Date:
11/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  161158 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0001X , with the licence number: 18026 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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