Provider Demographics
NPI:1649744004
Name:LITTLE, KATIE ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ELIZABETH
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 1:8175 STRATFORD DR APT 1611
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-7075
Mailing Address - Country:US
Mailing Address - Phone:330-647-3201
Mailing Address - Fax:330-750-0203
Practice Address - Street 1:857 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1170
Practice Address - Country:US
Practice Address - Phone:330-923-9585
Practice Address - Fax:330-923-2290
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005909RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant