Provider Demographics
NPI:1356214878
Name:VAN LITH, MARJORIE LYNN (CNA)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:LYNN
Last Name:VAN LITH
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:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:HECLA
Mailing Address - State:SD
Mailing Address - Zip Code:57446-0126
Mailing Address - Country:US
Mailing Address - Phone:712-470-0927
Mailing Address - Fax:
Practice Address - Street 1:201 4TH ST
Practice Address - Street 2:
Practice Address - City:HECLA
Practice Address - State:SD
Practice Address - Zip Code:57446-8006
Practice Address - Country:US
Practice Address - Phone:712-470-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND102397376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker