Provider Demographics
NPI:1366328049
Name:LIVINGSTON, SIERRA MAE
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:MAE
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962-1224
Mailing Address - Country:US
Mailing Address - Phone:304-960-3585
Mailing Address - Fax:
Practice Address - Street 1:144 8TH ST
Practice Address - Street 2:
Practice Address - City:RAINELLE
Practice Address - State:WV
Practice Address - Zip Code:25962-1224
Practice Address - Country:US
Practice Address - Phone:304-960-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant