Provider Demographics
NPI:1407605397
Name:LIVINGSTON, BRYANNA KAY (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:BRYANNA
Middle Name:KAY
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4347 DANBURY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53403-4022
Mailing Address - Country:US
Mailing Address - Phone:262-902-2855
Mailing Address - Fax:
Practice Address - Street 1:4347 DANBURY LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53403-4022
Practice Address - Country:US
Practice Address - Phone:262-902-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15349-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner