Basic Information
| Provider Information | |||||||||
| NPI: | 1164555280 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LITTRELL | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | RD LD CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3520 SW 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666062806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853680440 | ||||||||
| FaxNumber: | 7853540591 | ||||||||
| Practice Location | |||||||||
| Address1: | 3520 SW 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853680440 | ||||||||
| FaxNumber: | 7853540591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 05/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 1912 | KS | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
ID Information
| ID | Type | State | Issuer | Description | 068002362 | 01 | KS | MEDICARE PTAN | OTHER |