Provider Demographics
NPI:1548440910
Name:VAUGHNS, RABIA LYNNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:RABIA
Middle Name:LYNNE
Last Name:VAUGHNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RABIA
Other - Middle Name:LYNNE
Other - Last Name:ZALEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MMS, PA-C
Mailing Address - Street 1:3515 BRASELTON HWY
Mailing Address - Street 2:BLDG E-2
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-5926
Mailing Address - Country:US
Mailing Address - Phone:770-614-6630
Mailing Address - Fax:
Practice Address - Street 1:3515 BRASELTON HWY
Practice Address - Street 2:BLDG E-2
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-5926
Practice Address - Country:US
Practice Address - Phone:770-614-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5609363A00000X
GA005609363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant