Basic Information
Provider Information
NPI: 1316925720
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LITTLE
FirstName: KRISTEN
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6000 UNIVERSITY AVE
Address2: SUITE 203
City: WEST DES MOINES
State: IA
PostalCode: 502668203
CountryCode: US
TelephoneNumber: 5152412200
FaxNumber: 5152412201
Practice Location
Address1: 6000 UNIVERSITY AVE
Address2: SUITE 203
City: WEST DES MOINES
State: IA
PostalCode: 502668203
CountryCode: US
TelephoneNumber: 5152412200
FaxNumber: 5152412201
Other Information
ProviderEnumerationDate: 01/05/2006
LastUpdateDate: 10/19/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LX0001X067759IAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology

No ID Information.


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