Healthcare Provider Details

I. General information

NPI: 1275785248
Provider Name (Legal Business Name): AMY LYNN LITTLE PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 W KATHLEEN AVE
COEUR D ALENE ID
83815-8392
US

IV. Provider business mailing address

2059 W SYLAS CT
RATHDRUM ID
83858-5096
US

V. Phone/Fax

Practice location:
  • Phone: 208-665-4733
  • Fax:
Mailing address:
  • Phone: 208-775-9533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberP6198
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60020708
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP6198
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: