Provider Demographics
NPI:1013588557
Name:LIVENGOOD, DIANNA ALICIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:ALICIA
Last Name:LIVENGOOD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:ALICIA
Other - Last Name:LAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3209
Mailing Address - Country:US
Mailing Address - Phone:614-266-9922
Mailing Address - Fax:
Practice Address - Street 1:72 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3209
Practice Address - Country:US
Practice Address - Phone:614-266-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily