MEDICARE: DENISE LITTLE ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner		OR

General Provider Information

NPI Number	:	1598704041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE LITTLE ANP

Provider Business Mailing Address
First Line	:	PO BOX 568
Second Line	:
City	:	CORNELIUS
State	:	OR
Zip	:	97113-0568
Country	:	US
Telephone Number	:	503-359-5564
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 N HIGHWAY 99W
Second Line	:
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128-2757
Country	:	US
Telephone Number	:	503-472-1338
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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Directions to “ DENISE LITTLE ANP” Practice Location

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