Basic Information
| Provider Information | |||||||||
| NPI: | 1154572667 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIVSHIN | ||||||||
| FirstName: | VERA | ||||||||
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| Credential: | ANP-BC, WHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 158 WOLOMOLOPOAG ST | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020672828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813633640 | ||||||||
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| Practice Location | |||||||||
| Address1: | 416 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | RAYNHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027671737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088285020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2008 | ||||||||
| LastUpdateDate: | 06/16/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 267562 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LW0102X | 267562 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.