Healthcare Provider Details

I. General information

NPI: 1295136901
Provider Name (Legal Business Name): ASHLEY LITTLE MSN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2846 MOODY PKWY SUITE 300
MOODY AL
35004-3328
US

IV. Provider business mailing address

2846 MOODY PKWY SUITE 300
MOODY AL
35004-3328
US

V. Phone/Fax

Practice location:
  • Phone: 205-640-1756
  • Fax: 205-640-1796
Mailing address:
  • Phone: 205-640-1756
  • Fax: 205-640-1796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-114193
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: