Provider Demographics
NPI:1164050902
Name:LITTLETON, ELISABETH SUSANNE (AGCNS-BC, APRXN)
Entity Type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:SUSANNE
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:AGCNS-BC, APRXN
Other - Prefix:MRS
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:LITTLETON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AGCNS-BC, APRXN
Mailing Address - Street 1:6415 MONTANO PL
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6415 MONTANO PL
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108
Practice Address - Country:US
Practice Address - Phone:720-635-2968
Practice Address - Fax:720-200-4906
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995264-CNS364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology