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MRS. JERRICA BRIANNE VAUGHAN CPNP-PC NPI 1245768662


NPI Information

NPI: 1245768662
Provider Name: MRS. JERRICA BRIANNE VAUGHAN, CPNP-PC
Classification: Pediatrics - 2080P0006X
Entity Type: Individual

Specialization: Developmental - Behavioral Pediatrics

Address:
4855 S MOORLAND RD STE 250
NEW BERLIN, WI
ZIP 53151
Phone: (262) 789-6020
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MRS. Jerrica Brianne Vaughan, CPNP-PC is a developmental - behavioral pediatrics pediatrics in New Berlin, WI. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. MRS. Jerrica Brianne Vaughan, CPNP-PC NPI is 1245768662. 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:

4855 S MOORLAND RD STE 250
NEW BERLIN, WI
ZIP 53151-494
Phone: (262) 789-6020
Fax: (262) 789-6025

The enumeration date for this NPI number is 5/30/2017 and was last updated on 7/10/2023.


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
12080P0006XPediatricsDevelopmental - Behavioral Pediatrics20227463WISCONSINYes
2163W00000XRegistered Nurse226174WISCONSINNo
3363LP0200XNurse PractitionerPediatrics7420WISCONSINNo

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
11245768662MEDICAIDWISCONSIN

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: 5/5/2024

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