MEDICARE: MS. SHEWANNA LIVINGSTON N.D, CAM

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
1	175F00000X	Naturopath	ZGW3UJDYXM	ZZ

General Provider Information

NPI Number	:	1588553481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHEWANNA LIVINGSTON N.D, CAM

Provider Business Mailing Address
First Line	:	1800 ASHBOURNE RD UNIT 8901
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-2560
Country	:	US
Telephone Number	:	267-531-8686
Fax Number	:

Provider Business Practice Location Address
First Line	:	4117 LANCASTER AVE # 4117
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-1726
Country	:	US
Telephone Number	:	646-420-4202
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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