Individual
MS. SHELLEY LYNNE LITTLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
250 N ORTONVILLE RD STE C, ORTONVILLE, MI 48462-8308
(248) 793-7113
Mailing address
250 N ORTONVILLE RD STE C, ORTONVILLE, MI 48462-8308
(248) 793-7113
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003410
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0652511990
BCBSM IND PIN
MI
01
—
SL003410
BCBS STATE LICENSE
MI
Enumeration date
03/26/2007
Last updated
09/15/2020
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