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General NPI Number Information
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NPI Number | 1013058635
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Entity Type | Individual
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Provider Name | LISA MARIE LIVINGSTON RN
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 15533 W PARADISE LN
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City | SURPRISE
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State | AZ
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Zip | 85374-5851
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Country | US
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Telephone | 623-546-7288
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Fax | 623-975-4380
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Provider Business Mailing Address
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Address Line | 15533 W PARADISE LN
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City | SURPRISE
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State | AZ
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Zip | 85374-5851
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Country | US
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Telephone | 623-546-7288
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Fax | 623-975-4380
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 073531
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License Number State | AZ
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