Healthcare Provider Details

I. General information

NPI: 1417196411
Provider Name (Legal Business Name): CARA-LEA PEARL LITTLE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

103 CANYON DR
CLARKSVILLE TN
37042-3791
US

V. Phone/Fax

Practice location:
  • Phone: 240-826-7072
  • Fax: 240-826-7040
Mailing address:
  • Phone: 703-955-6118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110002959
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2277
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number2277
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC0004225
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: