Provider Demographics
NPI:1801431564
Name:LITTLEFIELD, BROOKE ASHLEY
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ASHLEY
Last Name:LITTLEFIELD
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 1:155 HANSCOM RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:ME
Mailing Address - Zip Code:04901-2921
Mailing Address - Country:US
Mailing Address - Phone:207-314-4412
Mailing Address - Fax:
Practice Address - Street 1:155 HANSCOM RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:ME
Practice Address - Zip Code:04901-2921
Practice Address - Country:US
Practice Address - Phone:207-314-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-16
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN66362163W00000X
RIAPRN02688363L00000X
390200000X
MECNP191334363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program