Provider Demographics
NPI:1871776948
Name:LITTLE ELK, KAREN (RN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:LITTLE ELK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BX 559
Mailing Address - Street 2:WRUSD #8 SPECIAL EDUCATION DEPT
Mailing Address - City:FT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504
Mailing Address - Country:US
Mailing Address - Phone:928-729-6827
Mailing Address - Fax:928-729-7630
Practice Address - Street 1:NAVAJO ROUTE 12
Practice Address - Street 2:WINDOW ROCK UNIFIED SCHOOL DISTRICT #8
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504
Practice Address - Country:US
Practice Address - Phone:928-729-6754
Practice Address - Fax:928-729-7630
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN064359163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ689838Medicare PIN