Provider Demographics
NPI:1265984439
Name:LIVINGSTON, KIMBERLY (RPH)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40221 N 2ND DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0801
Mailing Address - Country:US
Mailing Address - Phone:623-640-7918
Mailing Address - Fax:
Practice Address - Street 1:40221 N 2ND DR
Practice Address - Street 2:
Practice Address - City:DESERT HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85086-0801
Practice Address - Country:US
Practice Address - Phone:623-640-7918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS011005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist