Provider Demographics
NPI:1508820853
Name:LITTLE, AUDREY (PA-C)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 BILTMORE AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4565
Mailing Address - Country:US
Mailing Address - Phone:828-258-9533
Mailing Address - Fax:828-253-4434
Practice Address - Street 1:445 BILTMORE AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4565
Practice Address - Country:US
Practice Address - Phone:828-258-9533
Practice Address - Fax:828-253-4434
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100768363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCR49086Medicare UPIN
NC2752687Medicare ID - Type Unspecified