Provider Demographics
NPI:1073589750
Name:LIVINGSTON, CAROL A (CRNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-3511
Mailing Address - Country:US
Mailing Address - Phone:256-739-4144
Mailing Address - Fax:256-739-0445
Practice Address - Street 1:117 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3511
Practice Address - Country:US
Practice Address - Phone:256-739-4144
Practice Address - Fax:256-739-0445
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1060431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00176407OtherPALMETTO GBA RAILROAD MCR
ALS41940Medicare UPIN