Provider Demographics
NPI:1578025524
Name:LITTLE, KENDALL (RN)
Entity Type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 KNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-2722
Mailing Address - Country:US
Mailing Address - Phone:757-544-6777
Mailing Address - Fax:
Practice Address - Street 1:233 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-2722
Practice Address - Country:US
Practice Address - Phone:757-544-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001251748163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse