Provider Demographics
NPI:1639357064
Name:LITTLE, LYNN P (RN)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:P
Last Name:LITTLE
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 1:6505 LANDMARK DR
Mailing Address - Street 2:#300
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5999
Mailing Address - Country:US
Mailing Address - Phone:435-615-3910
Mailing Address - Fax:
Practice Address - Street 1:6505 LANDMARK DR
Practice Address - Street 2:#300
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5999
Practice Address - Country:US
Practice Address - Phone:435-615-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT356973-3102163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator