Provider Demographics
NPI:1316943541
Name:LIVINGSTON, KAREN (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:270 FARMINGTON AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1909
Mailing Address - Country:US
Mailing Address - Phone:860-549-8276
Mailing Address - Fax:860-674-8084
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 607
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-549-3210
Practice Address - Fax:860-247-3803
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2012-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT001224207X00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4210986Medicaid
CT890000204Medicare PIN
CTS91049Medicare UPIN