Provider Demographics
NPI:1043521842
Name:LITTLEJOHN, NAKIA RENEE (PMHNP-BC, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:NAKIA
Middle Name:RENEE
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:SAINT ELMO
Mailing Address - State:AL
Mailing Address - Zip Code:36568-0063
Mailing Address - Country:US
Mailing Address - Phone:256-343-3704
Mailing Address - Fax:586-204-0601
Practice Address - Street 1:200 MAIN STREET
Practice Address - Street 2:UNIT 1 AND 2
Practice Address - City:WEAVER
Practice Address - State:AL
Practice Address - Zip Code:36277
Practice Address - Country:US
Practice Address - Phone:256-581-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111424163WA0400X, 163WG0000X, 363LF0000X, 363LP0808X
GARN2734232084A0401X, 363LP0808X
VA0024180572363LP0808X, 163WA0400X
MS890726163WA0400X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1063439065OtherNPI GROUP PAYEE NUMBER
AL630000013Medicaid
AL011856OtherMEDICARE GROUP NUMBER