Provider Demographics
NPI:1750827226
Name:LITTLEFIELD, JENESSA
Entity Type:Individual
Prefix:MRS
First Name:JENESSA
Middle Name:
Last Name:LITTLEFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 W 730 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-4947
Mailing Address - Country:US
Mailing Address - Phone:208-201-6111
Mailing Address - Fax:801-373-0639
Practice Address - Street 1:1463 W 730 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-4947
Practice Address - Country:US
Practice Address - Phone:208-201-6111
Practice Address - Fax:801-373-0639
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist