Provider Demographics
NPI:1205105830
Name:LIVINGSTON, GRACE EMMANUEL (HHA)
Entity type:Individual
Prefix:
First Name:GRACE EMMANUEL
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:BERNICE GASSOP
Other - Middle Name:LEVESTINE
Other - Last Name:TOUKAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HHA
Mailing Address - Street 1:11235 OAK LEAF DR
Mailing Address - Street 2:703
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:240-386-9467
Mailing Address - Fax:
Practice Address - Street 1:6323 GEORGIA AVE NW STE 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1101
Practice Address - Country:US
Practice Address - Phone:202-506-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide