Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tara Lynn Livingston, FPAAPRN

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1417509407

Tara Lynn Livingston, FPAAPRN is a Nurse Practitioner in Peoria, Illinois. Qualified in 2019, 7 years ago. Practices with Edgewood Clinical Services PC, a 292-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
7
Licensed in
IL
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

5901 N Prospect Rd Ste 202
Peoria, IL 61614-4358
Phone: (888) 428-7890
Fax: (877) 428-7891
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3315 N Seminary St, Galesburg, IL 61401-1251 — (309) 344-1000

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 277002042 (IL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 377001970 (IL)

Record details

NPI number1417509407
Entity typeIndividual (Type 1)
GenderFemale
Credentials FPAAPRN
Sole proprietorNo
NPI enumeratedJuly 10, 2019
Last updated in NPPESJuly 13, 2022
Certification dateJuly 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Edgewood Clinical Services P.C. — 292 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Peoria