Provider Demographics
NPI:1114747185
Name:LIVINGSTON, EMILY JO I
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JO
Last Name:LIVINGSTON
Suffix:I
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 1:6746 WESTERMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:HARROD
Mailing Address - State:OH
Mailing Address - Zip Code:45850
Mailing Address - Country:US
Mailing Address - Phone:765-313-2138
Mailing Address - Fax:
Practice Address - Street 1:6746 WESTERMINSTER ST
Practice Address - Street 2:
Practice Address - City:HARROD
Practice Address - State:OH
Practice Address - Zip Code:45850
Practice Address - Country:US
Practice Address - Phone:765-313-2138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide