Provider Demographics
NPI:1942341367
Name:LIVINGSTON, JOANNE M (AP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:M
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AP
Mailing Address - Street 1:1628 GABLE CT
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3189
Mailing Address - Country:US
Mailing Address - Phone:321-452-1277
Mailing Address - Fax:
Practice Address - Street 1:1905 KNOX MCRAE DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5359
Practice Address - Country:US
Practice Address - Phone:321-268-9433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2301171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist