Provider Demographics
NPI:1396348348
Name:LITTLETON, GINGER SMITH
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:SMITH
Last Name:LITTLETON
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 1:5646 CHASE MILLS DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7060
Mailing Address - Country:US
Mailing Address - Phone:614-886-5429
Mailing Address - Fax:
Practice Address - Street 1:5646 CHASE MILLS DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7060
Practice Address - Country:US
Practice Address - Phone:614-886-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2572527OtherDODD CONTRACT NUMBER