Healthcare Provider Details

I. General information

NPI: 1124489679
Provider Name (Legal Business Name): COURTNEY LITTLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 HOSPITAL DR STE 100
SOUTH WILLIAMSON KY
41503-4095
US

IV. Provider business mailing address

306 HOSPITAL DR STE 100
SOUTH WILLIAMSON KY
41503-4095
US

V. Phone/Fax

Practice location:
  • Phone: 606-237-1789
  • Fax: 606-237-1797
Mailing address:
  • Phone: 606-237-1789
  • Fax: 606-237-1797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010052
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: