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General NPI Number Information
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NPI Number | 1528438280
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Entity Type | Individual
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Provider Name | MICHELLE LITTLE PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 2835 FORT MISSOULA RD STE 101
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City | MISSOULA
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State | MT
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Zip | 59804-7424
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Country | US
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Telephone | 406-728-0285
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Fax | 406-728-0613
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Provider Business Mailing Address
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Address Line | 2835 FORT MISSOULA RD STE 101
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City | MISSOULA
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State | MT
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Zip | 59804-7424
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Country | US
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Telephone | 406-728-0285
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Fax | 406-728-0613
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA60583630
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 132862
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License Number State | MT
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