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General NPI Number Information
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NPI Number | 1750899191
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Entity Type | Individual
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Provider Name | CHRISTIE M. LIVENGOOD CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2018
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 12301 AMHERST AVE NE
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City | CUMBERLAND
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State | MD
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Zip | 21502-8123
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Country | US
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Telephone | 240-727-7740
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Fax | 240-512-8564
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Provider Business Mailing Address
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Address Line | 104 W CREEK RUN LOOP
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City | FORT ASHBY
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State | WV
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Zip | 26719-5002
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Country | US
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Telephone | 240-727-7740
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Fax | 301-729-0180
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AC002277
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License Number State | MD
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