Provider Demographics
NPI:1346993490
Name:LITTLEJOHN, ANGEL (NEMT)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:NEMT
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:
Other - Last Name:LITTLEJOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1802 E LOOMAN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67219-4530
Mailing Address - Country:US
Mailing Address - Phone:316-613-9598
Mailing Address - Fax:
Practice Address - Street 1:1802 E LOOMAN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67219-4530
Practice Address - Country:US
Practice Address - Phone:316-613-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)