1699022517 NPI number — MRS. KRISTIE MARIE LITTLE NURSING ASSISTANT

Table of content: MRS. KRISTIE MARIE LITTLE NURSING ASSISTANT (NPI 1699022517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699022517 NPI number — MRS. KRISTIE MARIE LITTLE NURSING ASSISTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTLE
Provider First Name:
KRISTIE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NURSING ASSISTANT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699022517
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BLDG 301 ANDREWS AVE
Provider Second Line Business Mailing Address:
LYSTER ARMY HEALTH CLINIC
Provider Business Mailing Address City Name:
FORT RUCKER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36362-5333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-255-7341
Provider Business Mailing Address Fax Number:
334-255-7368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BLDG 301 ANDREWS AVE
Provider Second Line Business Practice Location Address:
LYSTER ARMY HEALTH CLINIC
Provider Business Practice Location Address City Name:
FORT RUCKER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36362-5333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-255-7341
Provider Business Practice Location Address Fax Number:
334-255-7368
Provider Enumeration Date:
08/09/2012

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: 376K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com