Provider Demographics
NPI:1336269869
Name:LITTLE, DIANE MAUREEN (RN)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MAUREEN
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 1:29040 BRIDGEHAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5596
Mailing Address - Country:US
Mailing Address - Phone:951-719-1483
Mailing Address - Fax:
Practice Address - Street 1:29040 BRIDGEHAMPTON RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5596
Practice Address - Country:US
Practice Address - Phone:951-719-1483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389524163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse