Healthcare Provider Details

I. General information

NPI: 1598447500
Provider Name (Legal Business Name): LANI MICHAELE LITTLEJOHN RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 WEST 10TH STREET
GROVE OK
74344-3310
US

IV. Provider business mailing address

310 S BROADWAY ST
GROVE OK
74344-3310
US

V. Phone/Fax

Practice location:
  • Phone: 918-786-3003
  • Fax:
Mailing address:
  • Phone: 918-786-3003
  • Fax: 918-786-9365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR0107362
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: