Provider Demographics
NPI:1376268318
Name:LIVINGSTON, BARBARA RENEE' (RN BSN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:RENEE'
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11257 NS 166 RD
Mailing Address - Street 2:
Mailing Address - City:GATE
Mailing Address - State:OK
Mailing Address - Zip Code:73844-0900
Mailing Address - Country:US
Mailing Address - Phone:580-651-7392
Mailing Address - Fax:
Practice Address - Street 1:11257 NS 166 RD
Practice Address - Street 2:
Practice Address - City:GATE
Practice Address - State:OK
Practice Address - Zip Code:73844-0900
Practice Address - Country:US
Practice Address - Phone:580-651-7392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0126814163WA0400X, 163WC1600X, 163WE0003X, 163WM0705X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical