Provider Demographics
NPI:1720191372
Name:LITTLE, VANESSA (DO)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WAYMAN LN
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-1625
Mailing Address - Country:US
Mailing Address - Phone:207-266-8303
Mailing Address - Fax:
Practice Address - Street 1:10 WAYMAN LN
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1625
Practice Address - Country:US
Practice Address - Phone:207-266-8303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2104207QH0002X
CA20A10762207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine