Individual
MYLYNDA S LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNP
Contact information
Practice address
347 NORTH SMITH AVENUE, CHILDRENS SPECIALTY CLINIC HEMATOLOGY ONCOLOGY STPL, ST PAUL, MN 55102
(651) 220-6732
(651) 220-6005
Mailing address
2910 CENTRE POINTE DRIVE, CHILDRENS HEALTH CARE 35 121A, ROSEVILLE, MN 55113
(651) 855-2327
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R1465987
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
R1465987
MN
363LP2300X
Primary Care Nurse Practitioner
R1465987
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433657000
—
MN
Enumeration date
11/02/2006
Last updated
09/19/2012
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