Provider Demographics
NPI:1518650449
Name:LITTLE, SINDY ANN
Entity Type:Individual
Prefix:
First Name:SINDY
Middle Name:ANN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 MARTIN LUTHER KING JR BLVD # 1024
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5216
Mailing Address - Country:US
Mailing Address - Phone:252-259-6695
Mailing Address - Fax:
Practice Address - Street 1:2809 BETTYE GRESHAM LN
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-0006
Practice Address - Country:US
Practice Address - Phone:252-259-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29439862172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver