MRS. MARTIE BREWER VAUGHN F.N.P. NPI 1245312404

NPI Information

  • NPI: 1245312404
  • Provider Name: MRS. MARTIE BREWER VAUGHN, F.N.P.
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1014 HOLLAND AVE
    PHILADELPHIA, MS
    ZIP 39350
  • Phone: (606) 656-4371

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NPI Details

MRS. Martie Brewer Vaughn, F.N.P. is a family nurse practitioner in Philadelphia, MS. MRS. Martie Brewer Vaughn, F.N.P. NPI is 1245312404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1014 HOLLAND AVE
PHILADELPHIA, MS
ZIP 39350-160
Phone: (606) 656-4371

The NPI 1245312404 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyR805579MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100118801MEDICAIDMISSISSIPPI
2S42427MEDICARE UPINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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