Provider Demographics
NPI:1548853948
Name:LITTLEWIND, ALLENE NIKKI (CNA)
Entity type:Individual
Prefix:MRS
First Name:ALLENE
Middle Name:NIKKI
Last Name:LITTLEWIND
Suffix:
Gender:F
Credentials:CNA
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 564
Mailing Address - Street 2:
Mailing Address - City:FORT TOTTEN
Mailing Address - State:ND
Mailing Address - Zip Code:58335-0564
Mailing Address - Country:US
Mailing Address - Phone:701-230-5202
Mailing Address - Fax:
Practice Address - Street 1:1015 BELLILE ST
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:ND
Practice Address - Zip Code:58370-7010
Practice Address - Country:US
Practice Address - Phone:701-766-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND750783747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDND3263918Medicaid