Provider Demographics
NPI:1053819763
Name:LITTLETON, TAMEKA (RN)
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22750 WREXFORD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-6569
Mailing Address - Country:US
Mailing Address - Phone:313-850-5763
Mailing Address - Fax:
Practice Address - Street 1:22750 WREXFORD DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-6569
Practice Address - Country:US
Practice Address - Phone:313-850-5763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704282167163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse