Individual
MARIE NICHOLE LIVESEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 FETTLER PARK DR, DUMFRIES, VA 22025-2050
(703) 441-7500
Mailing address
100 BREWSTER BLVD, NAVAL HOSPITAL CAMP LEJEUNE ATTN: GME, CAMP LEJEUNE, NC 28547-2575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0102208602
VA
207Q00000X
Family Medicine Physician
Primary
01081198A
IN
Other
Enumeration date
04/06/2017
Last updated
08/13/2025
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