Provider Demographics
NPI:1871633412
Name:LYTTLE, JESSICA DAWN (NR EMT-B)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:DAWN
Last Name:LYTTLE
Suffix:
Gender:F
Credentials:NR EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PINCH GUT RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27921-7635
Mailing Address - Country:US
Mailing Address - Phone:252-548-8353
Mailing Address - Fax:
Practice Address - Street 1:HSWL OPMED
Practice Address - Street 2:300 EAST MAIN ST.
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:252-548-8353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other