Provider Demographics
NPI:1194990283
Name:LITTON, KATHLEEN RUTH (ARNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RUTH
Last Name:LITTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6690 W CRESTLINE AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0677
Mailing Address - Country:US
Mailing Address - Phone:303-818-6945
Mailing Address - Fax:
Practice Address - Street 1:3235 MILL VISTA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2440
Practice Address - Country:US
Practice Address - Phone:303-876-8332
Practice Address - Fax:303-876-8325
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990334NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95506322Medicaid
COPTAN:325690YTWBMedicare PIN