Individual
DIANE CAMPBELL LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3686 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-8463
(850) 892-8045
(850) 892-8039
Mailing address
3686 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-8463
(850) 892-8045
(850) 892-8039
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
ARNPRN839422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
761912000
—
FL
01
—
Y9808
BCBS
FL
Enumeration date
09/21/2005
Last updated
09/01/2011
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