Provider Demographics
NPI:1871540286
Name:LITTLEPAGE, NANCY R (APRN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:LITTLEPAGE
Suffix:
Gender:F
Credentials:APRN
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:1 AUDUBON PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1318
Practice Address - Country:US
Practice Address - Phone:502-636-7225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004691363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000381217OtherBCBS
KY50021013OtherPASSPORT
KY000000596966OtherANTHEM
IN200869400Medicaid
KY78015260Medicaid
KY3547253000OtherPASSPORT ADVANTAGE
KY311192100OtherBLACK LUNG
IN200869400Medicaid
KY0601429Medicare PIN
KY0935339Medicare PIN
KY000000381217OtherBCBS
996907Medicare ID - Type Unspecified
KY0683230Medicare PIN
KY0396849Medicare PIN
KY3547253000OtherPASSPORT ADVANTAGE
Q51891Medicare UPIN