Individual
AMY MARIE LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4176 STATE ROUTE 306, WILLOUGHBY, OH 44094-9203
(440) 918-4690
(440) 918-4694
Mailing address
PO BOX 781389, DETROIT, MI 48278-1389
(440) 918-4690
(440) 918-4694
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11970-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3103171
—
OH
01
—
RN 325805
CERTIFICATE OF AUTHORITY
OH
Enumeration date
11/04/2010
Last updated
07/21/2022
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