Individual
DEBRA ANN LIVERGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
2000 E LINCOLN RD, IDABEL, OK 74745-7353
(580) 286-6639
Mailing address
2000 E LINCOLN RD, IDABEL, OK 74745-7353
(580) 286-6639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
86244 00103672
OK
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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