Provider Demographics
NPI:1861552143
Name:LIVELY, FLORENCE M (RN)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:M
Last Name:LIVELY
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 1:727 FAIRVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-5493
Mailing Address - Country:US
Mailing Address - Phone:775-684-5000
Mailing Address - Fax:775-681-1811
Practice Address - Street 1:141 KEDDIE ST
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2820
Practice Address - Country:US
Practice Address - Phone:775-423-7141
Practice Address - Fax:775-423-4020
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19995163W00000X
NVRN19995163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse