Healthcare Provider Details

I. General information

NPI: 1912316720
Provider Name (Legal Business Name): MRS. CANDICE LITTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 INVERNESS CORS
BIRMINGHAM AL
35242-3779
US

IV. Provider business mailing address

895 CLOVER CIR
SPRINGVILLE AL
35146-2604
US

V. Phone/Fax

Practice location:
  • Phone: 205-218-7448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: