Healthcare Provider Details

I. General information

NPI: 1144630245
Provider Name (Legal Business Name): DEBBIE H LITTLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ENOLA RD
MORGANTON NC
28655-4608
US

IV. Provider business mailing address

300 ENOLA RD
MORGANTON NC
28655-4608
US

V. Phone/Fax

Practice location:
  • Phone: 828-433-2661
  • Fax: 828-438-6457
Mailing address:
  • Phone: 828-433-2661
  • Fax: 828-438-6457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number094369
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: