Provider Demographics
NPI:1720782741
Name:LITTLEWIND, ALYSSA
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:LITTLEWIND
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 1:201 MAIN ST W APT 18
Mailing Address - Street 2:
Mailing Address - City:MINNEWAUKAN
Mailing Address - State:ND
Mailing Address - Zip Code:58351-5000
Mailing Address - Country:US
Mailing Address - Phone:701-270-3935
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN ST W APT 18
Practice Address - Street 2:
Practice Address - City:MINNEWAUKAN
Practice Address - State:ND
Practice Address - Zip Code:58351-5000
Practice Address - Country:US
Practice Address - Phone:701-270-3935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant