GENIE B VAUGHAN


Address: 1065 E Broad St, Monticello, MS 39654-7703
Phone: 6015874051

GENIE B VAUGHAN (NPI# 1134231541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134231541
Entity Type Individual
Full Name GENIE B VAUGHAN
Other Name GENIE B RUSSELL
Credential RN, CFNP
Practice Address 1065 E Broad St
Monticello
MS 39654-7703
Mailing Address 179 Tom Sistrunk Rd
Jayess
MS 39641-3781
Practice Telephone 6015874051
Practice Fax Number 6015871256
Mailing Telephone 6015872678
Enumeration Date 2006-08-31
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
R776769 MS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MS 00124884 05

Office Location

Street Address 1065 E BROAD ST
City MONTICELLO
State MS
Zip Code 39654-7703

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083726491 Becky Jan Mercier Nurse Practitioner 1065 E Broad St, Monticello, MS 39654-7703 2006-08-31
1932721222 Southwest Mississippi Regional Medical Center Internal Medicine 1065 E Broad St, Monticello, MS 39654-7703 2020-05-11
1568833580 Atwood Emergency Physicians LLC Emergency Medicine 1065 E Broad St, Monticello, MS 39654-7703 2015-10-16
1942670930 Mississippi Em-i Medical Serives PC Physician Assistant 1065 E Broad St, Monticello, MS 39654-7703 2015-10-02
1275860926 Shannon Smith Occupational Therapy Assistant 1065 E Broad St, Monticello, MS 39654-7703 2009-11-17
1316172505 Kim Lewis Physical Therapist 1065 E Broad St, Monticello, MS 39654-7703 2009-05-18
1508054404 Jack Douglas Physical Therapist 1065 E Broad St, Monticello, MS 39654-7703 2007-10-05
1730303942 Southwest Mississippi Regional Medical Center Psychiatric Unit 1065 E Broad St, Monticello, MS 39654-7703 2007-04-12
1992829725 Southwest Mississippi Regional Medical Center General Acute Care Hospital 1065 E Broad St, Monticello, MS 39654-7703 2007-03-19
1255422457 Southwest Ms Regional Medical Center Thoracic Surgery (Cardiothoracic Vascular Surgery) 1065 E Broad St, Monticello, MS 39654-7703 2006-09-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013558824 Downhome Pharmacy, Inc. Pharmacy 606 W. Broad St, Monticello, MS 39654 2019-10-02
1700344066 Southwest Mississippi Regional Medical Center Surgery 1065 E Broad St., Monticello, MS 39654 2019-03-06
1457862229 Susan Nevels Pharmacist 1509 Highway 84 West, Monticello, MS 39654 2017-10-19
1326565417 David Warren Ready Pharmacist 1509 Hwy 84 West, Monticello, MS 39654 2017-08-29
1861664575 James Mikel Griffith II Physical Therapy Assistant 314 Main St, Ste C, Monticello, MS 39654 2008-04-02
1811169840 Southwest Mississippi Planning and Development District Clinic/Center 1477 Fe Sellers Highway, Monticello, MS 39654 2008-03-31
1447429089 Foot and Wound Institute of The South Clinic/Center 157 Fe Sellers Highway, Monticello, MS 39654 2008-02-28
1346431566 Amy Eaton Broome Physical Therapy Assistant 314 Main St Ste C, Monticello, MS 39654 2007-08-05
1881804532 Chris Gilbert Boyd Dentist 716 Brookhaven Street, Monticello, MS 39654 2007-05-23
1851463707 Brantley B. Pace Family Medicine 713 Watts St., Monticello, MS 39654 2006-11-15
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457968406 Sojnia Irene Johnson Nurse Practitioner 561 Country Oaks Ln, Monticello, KY 42633-5145 2020-09-24
1023622081 Marty Kyle Ballard Sr. Nurse Practitioner 698 Lower Brookhaven Rd, Monticello, MS 39654-9627 2020-09-06
1659918936 Shelby Mcmickle Nurse Practitioner 170 Brixie Rd, Monticello, AR 71655-9096 2019-12-05
1104462712 Ashley Leanna Huitt Nurse Practitioner Drew Memorial Health System, 778 Scogin Drive, Monticello, AR 71655 2019-11-19
1053964965 Faith Healthcare Inc Nurse Practitioner 126 Franklin Drive, Monticello, KY 42633 2019-07-19
1740757145 Karla Marie Wallace Nurse Practitioner 314 Main St Ste B, Monticello, MS 39654-3702 2018-10-24
1770039752 Jesse Bone Nurse Practitioner 766 Hl Ross Drive, Monticello, AR 71655 2016-08-30
1295196137 Miranda Tompkins Nurse Practitioner 1215 N Main St Ste 2, Monticello, KY 42633-2900 2016-03-18
1285065292 Teresa Conerly Nurse Practitioner 430 W Broad St, Monticello, MS 39654-7723 2013-12-02
1487089546 Doretha Bournes Nurse Practitioner 354 Cub Brown Rd, Monticello, MS 39654-7505 2013-09-09
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Competitor

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City MONTICELLO
Zip Code 39654

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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