MEDICARE: KAY LIVINGSTON RN

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	163W00000X	Registered Nurse	1900172	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN1900172	OTHER	FL	FLORIDA BOARD OF NURSING

General Provider Information

NPI Number	:	1881044204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY LIVINGSTON RN

Provider Business Mailing Address
First Line	:	7327 LEXINGTON LN
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33764-7024
Country	:	US
Telephone Number	:	727-204-5366
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 6TH ST S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-3720
Country	:	US
Telephone Number	:	727-894-8719
Fax Number	:

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

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	06/16/2016

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