Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Nicole Vaughn, AGNP-C

Individual provider Gerontology Nurse Practitioner · NPI 1124884895

Dominique Nicole Vaughn, AGNP-C is a Nurse Practitioner in Cordova, Tennessee. Qualified in 2023, 3 years ago. Practices with Theoria Medical, a 342-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
3
Licensed in
TN
In the registry since
2024

Practice location Address checks out

682 Woodland Fox Ln W
Cordova, TN 38018-1147
Phone: (901) 436-0542
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 35863 (TN)

Record details

NPI number1124884895
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedFebruary 21, 2024
Last updated in NPPESMay 12, 2025
Certification dateMay 12, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Theoria Medical — 342 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Cordova