Individual
STACI LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
N3507 COUNTRY RD M, NONE, WEST SALEM, WI 54669
(262) 623-0304
Mailing address
N3507 COUNTRY RD M, NONE, WEST SALEM, WI 54669
(262) 623-0304
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
116001
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11972-33
WI
Other
Enumeration date
06/09/2022
Last updated
05/05/2025
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