Healthcare Provider Details

I. General information

NPI: 1609578954
Provider Name (Legal Business Name): NALYSSA KIRSTEN LITTLE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2874 N CARSON ST STE 200
CARSON CITY NV
89706-1682
US

IV. Provider business mailing address

2874 N CARSON ST STE 200
CARSON CITY NV
89706-1682
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-7170
  • Fax: 775-461-3079
Mailing address:
  • Phone: 775-445-7170
  • Fax: 775-461-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO4190
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: