Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9313619 | FL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | NP18734 | CA |
NPI | 1013107994 |
---|---|
Provider Name | Carol L Livelli |
First Address | Sebastian, FL 32958-3289 |
Second Address | Sebastian, FL 32958-3289 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2007 |
Last Update Date | 06/12/2010 |