1619254224 NPI number — SUSAN SCANTLAND LITTLETON CNM

Table of content: SUSAN SCANTLAND LITTLETON CNM (NPI 1619254224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619254224 NPI number — SUSAN SCANTLAND LITTLETON CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTLETON
Provider First Name:
SUSAN
Provider Middle Name:
SCANTLAND
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCANTLAND
Provider Other First Name:
SUSAN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619254224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16370
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43216-6370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-859-1900
Provider Business Mailing Address Fax Number:
614-645-5517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3433 AGLER RD
Provider Second Line Business Practice Location Address:
SUITE 2800
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43219-3387
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-645-1600
Provider Business Practice Location Address Fax Number:
614-645-1347
Provider Enumeration Date:
11/10/2011

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: 367A00000X , with the licence number:  12865-NM , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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