1598725962 NPI number — MRS. KAREN DYRLAND LITTLETON NP

Table of content: MRS. KAREN DYRLAND LITTLETON NP (NPI 1598725962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598725962 NPI number — MRS. KAREN DYRLAND LITTLETON NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTLETON
Provider First Name:
KAREN
Provider Middle Name:
DYRLAND
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PLAVNIEKS
Provider Other First Name:
KAREN
Provider Other Middle Name:
ALINE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598725962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3413 DEER OAK CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVIEDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32766-8111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-366-7707
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 HOLT AVE
Provider Second Line Business Practice Location Address:
BOX 2727
Provider Business Practice Location Address City Name:
WINTER PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32789-4499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-646-2235
Provider Business Practice Location Address Fax Number:
407-646-2213
Provider Enumeration Date:
03/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC1400X , with the licence number:  3413412 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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