Provider Demographics
NPI:1194115048
Name:LITTLEJOHN, KELLI M (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:KELLI
Middle Name:M
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14108 BECKET RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2825
Mailing Address - Country:US
Mailing Address - Phone:216-262-0155
Mailing Address - Fax:
Practice Address - Street 1:14108 BECKET RD
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44120-2825
Practice Address - Country:US
Practice Address - Phone:216-262-0155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033525363L00000X
OH390024163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse