Healthcare Provider Details

I. General information

NPI: 1720627359
Provider Name (Legal Business Name): KENDALL HINTON LITTLE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDALL BROOKS HINTON

II. Dates (important events)

Enumeration Date: 12/30/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E WASHINGTON AVE
JONESBORO AR
72401-3111
US

IV. Provider business mailing address

7751 BELFORT PKWY STE 120
JACKSONVILLE FL
32256-6921
US

V. Phone/Fax

Practice location:
  • Phone: 904-372-3943
  • Fax:
Mailing address:
  • Phone: 904-372-3943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-933
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: