Most Relevant Information
Provider Data
| NPI Number: | 1003539487 |
| Provider Name: | KENDALL VAUGHAN CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163WN0002X |
| Specialty: | Registered Nurse |
| License Number: | R223013 |
Most Important Dates
| Enumeration Date: | 09/21/2022 |
| Last Updated: | 09/21/2022 |
Provider Practice Location
22 S GREENE ST
BALTIMORE
MD
212011590
Practice Location Phone/Fax
| Phone: | 4103286716 |
| Fax: |
Provider Mailing Location
120 KINGSTON PARK LN
MIDDLE RIVER
MD
212204903
Provider Mailing Phone/Fax
| Phone: | 3014482858 |
| Fax: |