Provider Demographics
NPI:1154562478
Name:LITTLE, DORIS ANN (CNA)
Entity type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:ANN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT BOTTOM
Mailing Address - State:PA
Mailing Address - Zip Code:17266-9718
Mailing Address - Country:US
Mailing Address - Phone:717-530-3156
Mailing Address - Fax:717-532-7385
Practice Address - Street 1:411 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT BOTTOM
Practice Address - State:PA
Practice Address - Zip Code:17266-9718
Practice Address - Country:US
Practice Address - Phone:717-530-3156
Practice Address - Fax:717-532-7385
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10012751251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care