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NPI Code Detail

MEDICARE: MARY LITTLEHORN FNP

MEDICARE: MARY LITTLEHORN FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WE0003XEmergency Registered NurseRN133474AZ
2363LF0000XFamily Nurse PractitionerF0113199AZ

General Provider Information

NPI Number : 1952645558
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LITTLEHORN FNP
Provider Business Mailing Address
First Line : 972 W DOBYNS LN
Second Line :
City : TUCSON
State : AZ
Zip : 85704-3771
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2732 N ALVERNON WAY
Second Line :
City : TUCSON
State : AZ
Zip : 85712-1804
Country : US
Telephone Number : 520-382-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2012
Last Update Date : 07/06/2021

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