Basic Information
| Provider Information | |||||||||
| NPI: | 1366982704 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LITTLE | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | BARRETT | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1365 WEST BRIERBROOK ROAD | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN- TENNESSEE | ||||||||
| PostalCode: | 38138 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 9016246517 | ||||||||
| FaxNumber: | 9016246521 | ||||||||
| Practice Location | |||||||||
| Address1: | 146 TIMBER CREEK DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CORDOVA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380184395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017514112 | ||||||||
| FaxNumber: | 9017519878 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2017 | ||||||||
| LastUpdateDate: | 06/19/2017 | ||||||||
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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 | 363LF0000X | 901839 | MS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | APN0000022253 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.