Provider Demographics
NPI:1871877902
Name:LIVINGSTON, SHAMIKA DAWN (LPN)
Entity type:Individual
Prefix:MS
First Name:SHAMIKA
Middle Name:DAWN
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-1705
Mailing Address - Country:US
Mailing Address - Phone:814-844-0195
Mailing Address - Fax:
Practice Address - Street 1:1337 E 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1705
Practice Address - Country:US
Practice Address - Phone:814-844-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN284419164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse