Individual
NICHOLAS GLEN LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 S BRUCE ST, MARSHALL, MN 56258-1934
(507) 532-9661
Mailing address
506 CONTINENTAL ST, MARSHALL, MN 56258-5548
(605) 661-0689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R035316
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
2208
MN
Other
Enumeration date
02/26/2018
Last updated
07/30/2019
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