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NPI Code Detail

MEDICARE: RENEE M. LIVAS

MEDICARE:   RENEE M. LIVAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1043796964
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE M. LIVAS
Provider Business Mailing Address
First Line : 4510 E CANYON TRL
Second Line :
City : COTTONWOOD
State : AZ
Zip : 86326-5909
Country : US
Telephone Number : 928-303-3507
Fax Number :
Provider Business Practice Location Address
First Line : 4510 E CANYON TRL
Second Line :
City : COTTONWOOD
State : AZ
Zip : 86326-5909
Country : US
Telephone Number : 928-303-3507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2018
Last Update Date : 07/13/2018

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Directions to “ RENEE M. LIVAS ” Practice Location

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