Provider Demographics
NPI:1922782416
Name:LITTLE, DAWN M (CNA)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:LITTLE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:AL
Mailing Address - Zip Code:35959-0212
Mailing Address - Country:US
Mailing Address - Phone:770-548-7993
Mailing Address - Fax:
Practice Address - Street 1:1210 COUNTY ROAD 131
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:AL
Practice Address - Zip Code:35959-2109
Practice Address - Country:US
Practice Address - Phone:770-548-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL92-1579020376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty