Individual
MRS. JENNIFER ANN LIVESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
22 CHRISTYS DR, BROCKTON, MA 02301-1839
(508) 580-4611
Mailing address
33 MILLERS BROOK DR, CUMBERLAND, RI 02864-6163
(401) 864-0763
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2283765
MA
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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