=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225070485
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CENE' L LIVINGSTON DNP, APRN-BC, CNE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2006
-----------------------------------------------------
Last Update Date | 08/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11109 SURREY HILLS BLVD
-----------------------------------------------------
City | YUKON
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73099-8155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-373-2400
-----------------------------------------------------
Fax | 405-373-4400
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6421 N COLLEGE AVE
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73132-7209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-476-6573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | R0066016
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R0066016
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------