Provider Demographics
NPI:1972597417
Name:STAGGS-LITTRELL, CARI DAWN (RD, CD)
Entity type:Individual
Prefix:
First Name:CARI
Middle Name:DAWN
Last Name:STAGGS-LITTRELL
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUNN MEMORIAL HOSPITAL
Mailing Address - Street 2:1600 23RD STREET
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421
Mailing Address - Country:US
Mailing Address - Phone:812-275-3331
Mailing Address - Fax:
Practice Address - Street 1:DUNN MEMORIAL HOSPITAL
Practice Address - Street 2:1600 23RD STREET
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421
Practice Address - Country:US
Practice Address - Phone:812-275-3331
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001432A133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCB0940EMedicare ID - Type UnspecifiedDIETITIAN
INP75460Medicare UPIN