Provider Demographics
NPI:1194162982
Name:LIVINGSTONE, MARY CHRISTINE (LPN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CHRISTINE
Last Name:LIVINGSTONE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CHRISTINE
Other - Last Name:ASHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:5160 COUNTY ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:NY
Mailing Address - Zip Code:14821-9521
Mailing Address - Country:US
Mailing Address - Phone:607-229-4079
Mailing Address - Fax:
Practice Address - Street 1:5160 COUNTY ROUTE 125
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:NY
Practice Address - Zip Code:14821-9521
Practice Address - Country:US
Practice Address - Phone:607-229-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084872164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse