Healthcare Provider Details

I. General information

NPI: 1629995139
Provider Name (Legal Business Name): JORDAN LIVINGSTON PHARMD, BCEMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S LIMESTONE
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

3616 GLEN OAK WAY
LEXINGTON KY
40515-1214
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License Number025081
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: