Provider Demographics
NPI:1598447500
Name:LITTLEJOHN, LANI MICHAELE (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:LANI
Middle Name:MICHAELE
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63311 E 293 RD
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-7075
Mailing Address - Country:US
Mailing Address - Phone:918-533-8211
Mailing Address - Fax:
Practice Address - Street 1:310 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-3310
Practice Address - Country:US
Practice Address - Phone:918-786-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0107362163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool