Provider Demographics
NPI:1366634834
Name:LITTLE, ALLISON K (PA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:K
Last Name:LITTLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:K
Other - Last Name:LIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 896208
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-6208
Mailing Address - Country:US
Mailing Address - Phone:812-660-0766
Mailing Address - Fax:
Practice Address - Street 1:8004 HIGHWAY 73 W
Practice Address - Street 2:
Practice Address - City:MT GILEAD
Practice Address - State:NC
Practice Address - Zip Code:27306-2730
Practice Address - Country:US
Practice Address - Phone:910-469-4100
Practice Address - Fax:910-469-4211
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51451363A00000X
NC0010-02646363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant