Provider Demographics
NPI:1144766080
Name:LITTLE, MEGAN (ND, NBC-HWC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:ND, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12817 CRYSTAL AVE
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-2053
Mailing Address - Country:US
Mailing Address - Phone:503-724-1408
Mailing Address - Fax:
Practice Address - Street 1:12817 CRYSTAL AVE
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030
Practice Address - Country:US
Practice Address - Phone:503-724-1408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2022-09-12
Deactivation Date:2021-06-02
Deactivation Code:
Reactivation Date:2021-09-02
Provider Licenses
StateLicense IDTaxonomies
A-3155725171400000X
MO175F00000X
OR4045175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171400000XOther Service ProvidersHealth & Wellness Coach