MEDICARE: BROOKE ASHLEY LITTLEFIELD

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
1	163W00000X	Registered Nurse	RN66362	ME
2	363L00000X	Nurse Practitioner	APRN02688	RI
3	390200000X	Student in an Organized Health Care Education/Training Program
4	363L00000X	Nurse Practitioner	CNP191334	ME

General Provider Information

NPI Number	:	1801431564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ASHLEY LITTLEFIELD

Provider Business Mailing Address
First Line	:	155 HANSCOM RD
Second Line	:
City	:	BENTON
State	:	ME
Zip	:	04901-2921
Country	:	US
Telephone Number	:	207-314-4412
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 HANSCOM RD
Second Line	:
City	:	BENTON
State	:	ME
Zip	:	04901-2921
Country	:	US
Telephone Number	:	207-314-4412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2019
Last Update Date	:	08/05/2021

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Directions to “ BROOKE ASHLEY LITTLEFIELD ” Practice Location

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