Ellen Vaughan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

097001 Issued in MO

Practice address

610 N. One Mile Road
Dexter, MO 63841

Phone

(573) 624-3600

NPI assigned

Jan 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215082680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10492 STATE HIGHWAY ZZ",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "63841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N. ONE MILE ROAD",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "63841",
            "telephone_number": "573-624-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "097001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wal-Mart Stores East LP (Walmart Pharmacy 10-0030)
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• Walgreen Co (Walgreens #15800)

• Family Nurse Practitioner in Dexter, MO
• Providers in Dexter, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.