Healthcare Provider Details

I. General information

NPI: 1972597417
Provider Name (Legal Business Name): CARI DAWN STAGGS-LITTRELL R.D., C.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUNN MEMORIAL HOSPITAL 1600 23RD STREET
BEDFORD IN
47421
US

IV. Provider business mailing address

DUNN MEMORIAL HOSPITAL 1600 23RD STREET
BEDFORD IN
47421
US

V. Phone/Fax

Practice location:
  • Phone: 812-275-3331
  • Fax:
Mailing address:
  • Phone: 812-275-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number37001432A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: