Provider Demographics
NPI:1790982411
Name:LITCHFIELD, JOHN N (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:N
Last Name:LITCHFIELD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13232 WINDSONG LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-5301
Mailing Address - Country:US
Mailing Address - Phone:360-620-1639
Mailing Address - Fax:910-450-4194
Practice Address - Street 1:13232 WINDSONG LN
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-5301
Practice Address - Country:US
Practice Address - Phone:360-620-1639
Practice Address - Fax:910-450-4194
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235347367500000X
CA707196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse