Basic Information
| Provider Information | |||||||||
| NPI: | 1760858799 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LITTLE | ||||||||
| FirstName: | NATASHIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2917 | ||||||||
| Address2: | |||||||||
| City: | PIKEVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415012917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6062186280 | ||||||||
| FaxNumber: | 6062184562 | ||||||||
| Practice Location | |||||||||
| Address1: | 911 BY PASS ROAD CLINIC 6 | ||||||||
| Address2: | |||||||||
| City: | PIKEVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415011520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6062186406 | ||||||||
| FaxNumber: | 6062187506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2015 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 3009424 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LG0600X | 3009424 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LP0808X | 3009424 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.