Provider Demographics
NPI:1992061337
Name:LIVERNASH, JULIA MAY (RRT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MAY
Last Name:LIVERNASH
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1221
Mailing Address - Street 2:
Mailing Address - City:LOGANDALE
Mailing Address - State:NV
Mailing Address - Zip Code:89021-1221
Mailing Address - Country:US
Mailing Address - Phone:253-381-8419
Mailing Address - Fax:
Practice Address - Street 1:1120 N TOWN CENTER DR
Practice Address - Street 2:#120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6301
Practice Address - Country:US
Practice Address - Phone:702-868-7691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC20432279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care