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General NPI Number Information
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NPI Number | 1487073219
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Entity Type | Individual
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Provider Name | EARLINE LITTLE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 3080 HIGHWAY 15-401 E
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City | MC COLL
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State | SC
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Zip | 29570-6128
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Country | US
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Telephone | 843-523-5751
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Fax | 843-523-6040
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Provider Business Mailing Address
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Address Line | PO BOX 1090
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City | HARTSVILLE
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State | SC
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Zip | 29551-1090
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Country | US
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Telephone | 843-857-0111
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Fax | 843-309-8126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 19322
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License Number State | SC
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