Individual
JEANNETTE A. LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
1021 COOLIDGE ST, SUITE 2, GREENEVILLE, TN 37743-4672
(423) 636-2300
(423) 636-0348
Mailing address
1021 COOLIDGE ST, SUITE 2, GREENEVILLE, TN 37743-4672
(423) 636-2300
(423) 636-0348
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
RN0000120048
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053402701
GROUP NPI
TN
01
—
1427130178
NPI
TN
01
—
3661167
MEDICARE PPIN
TN
05
—
3661167
—
TN
Enumeration date
10/20/2006
Last updated
01/22/2008
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