Healthcare Provider Details

I. General information

NPI: 1437674363
Provider Name (Legal Business Name): ABIGAIL JEAN LIVINGSTON DNP, CPNP, RN, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL MCCLINTOCK

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE, ML 2010
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

5280 BEECHMONT AVE APT 4153
CINCINNATI OH
45230-1086
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4415
  • Fax: 513-636-7805
Mailing address:
  • Phone: 317-690-1779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0035185
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.517684
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: