Provider Demographics
NPI:1609509462
Name:LIVINGSTON, ELLIE ALAYNE
Entity Type:Individual
Prefix:MRS
First Name:ELLIE
Middle Name:ALAYNE
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 1:305 MARVIN AVE
Mailing Address - Street 2:
Mailing Address - City:VOLGA
Mailing Address - State:SD
Mailing Address - Zip Code:57071-2011
Mailing Address - Country:US
Mailing Address - Phone:509-572-5211
Mailing Address - Fax:
Practice Address - Street 1:300 22ND AVE
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2480
Practice Address - Country:US
Practice Address - Phone:605-696-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula