Provider Demographics
NPI:1568077857
Name:LIVINGSTON, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 CHERRY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:THURMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45685-9310
Mailing Address - Country:US
Mailing Address - Phone:740-645-0505
Mailing Address - Fax:
Practice Address - Street 1:3322 CHERRY RIDGE RD
Practice Address - Street 2:
Practice Address - City:THURMAN
Practice Address - State:OH
Practice Address - Zip Code:45685-9310
Practice Address - Country:US
Practice Address - Phone:740-645-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care