Provider Demographics
NPI:1205925658
Name:LITTLEFIELD, CAROL HANSEN (RN)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:HANSEN
Last Name:LITTLEFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:HANSEN
Other - Last Name:LITTLEFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:9977 BOTTLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:KELSEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95451-2831
Mailing Address - Country:US
Mailing Address - Phone:801-209-4404
Mailing Address - Fax:801-581-0922
Practice Address - Street 1:9977 BOTTLE ROCK RD
Practice Address - Street 2:
Practice Address - City:KELSEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95451-2831
Practice Address - Country:US
Practice Address - Phone:801-209-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA815659163W00000X
UT2034248900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174400000XOther Service ProvidersSpecialist