Provider Demographics
NPI:1326670696
Name:LITTLE, DIANA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11238 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44046-9718
Mailing Address - Country:US
Mailing Address - Phone:440-226-4891
Mailing Address - Fax:
Practice Address - Street 1:11238 PLANK RD
Practice Address - Street 2:
Practice Address - City:HUNTSBURG
Practice Address - State:OH
Practice Address - Zip Code:44046-9718
Practice Address - Country:US
Practice Address - Phone:440-226-4891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN113731164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse