Provider Demographics
NPI:1861696270
Name:LIVINGSTON, NANCY TRIBLEY (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:TRIBLEY
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1502 W. HWY. 54
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-493-3597
Mailing Address - Fax:919-419-0219
Practice Address - Street 1:1502 W. HWY. 54
Practice Address - Street 2:SUITE 302
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-493-3597
Practice Address - Fax:919-419-0219
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC189352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2217912AMedicare ID - Type Unspecified