IndividualActive
Jerrica Vaughan, CPNP-PC
NPI 1245768662 · Developmental - Behavioral Pediatrics Physician · New Berlin, WI
Provider details
- NPI number
- 1245768662
- Entity type
- Individual
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- License
- 20227463 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Nursing Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4855 S Moorland Rd Ste 250
New Berlin, WI 53151-7494
Phone: (262) 789-6020
Fax: (262) 789-6025
Approximate (ZIP-level) locationGet directions
Mailing address
9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Registry dates
- Enumerated
- 2017-05-30
- Last updated
- 2023-07-10
- Certified
- 2023-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.