Provider Demographics
NPI:1528704681
Name:LIVERMAN, NANNETTE E
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:E
Last Name:LIVERMAN
Suffix:
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 1:14184 SE 200TH CT
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-8246
Mailing Address - Country:US
Mailing Address - Phone:904-735-3970
Mailing Address - Fax:
Practice Address - Street 1:14184 SE 200TH CT
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-8246
Practice Address - Country:US
Practice Address - Phone:904-735-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health