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Jeannette Vaughn-Dotterer

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NPI Number Detailed Information

Provider Information:

Name: Jeannette Vaughn-Dotterer
Gender: F
Provider License Number If Given: 2896

NPI Information:

NPI: 1407859416
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: PO BOX 10097
Casa Grande, AZ 85230
Phone Number: 5208363446
Fax Number: 5208368807

Provider Business Practice Location Address:

Address: 865 N ARIZOLA RD
Casa Grande, AZ 85222
Phone Number: 5208363446
Fax Number: 5208368807

Provider Taxonomy:

Primary: 363A00000X
Secondary (if any):
State: AZ

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