Healthcare Provider Details

I. General information

NPI: 1417878166
Provider Name (Legal Business Name): KEITH LITTELL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 KING CT
KEENE NH
03431-4649
US

IV. Provider business mailing address

6 CADY ST
KEENE NH
03431-3520
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax: 800-480-7578
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number091254-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: