Provider Demographics
NPI:1871119669
Name:LIVINGSTON, DAYSHAUNA R (RN)
Entity type:Individual
Prefix:MISS
First Name:DAYSHAUNA
Middle Name:R
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6274 SELLERS ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49267-9618
Mailing Address - Country:US
Mailing Address - Phone:419-262-8306
Mailing Address - Fax:
Practice Address - Street 1:6274 SELLERS ST
Practice Address - Street 2:
Practice Address - City:OTTAWA LAKE
Practice Address - State:MI
Practice Address - Zip Code:49267-9618
Practice Address - Country:US
Practice Address - Phone:419-262-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.472690163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse