Provider Demographics
NPI:1619254224
Name:LITTLETON, SUSAN SCANTLAND (CNM)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:SCANTLAND
Last Name:LITTLETON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ANN
Other - Last Name:SCANTLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 16370
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-6370
Mailing Address - Country:US
Mailing Address - Phone:614-859-1900
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:3433 AGLER RD
Practice Address - Street 2:SUITE 2800
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3387
Practice Address - Country:US
Practice Address - Phone:614-645-1600
Practice Address - Fax:614-645-1347
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12865-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife