Provider Demographics
NPI:1801364963
Name:LITTLE, KIMBERLY TOWNSEND (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:TOWNSEND
Last Name:LITTLE
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MULLBURY PL
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5819
Mailing Address - Country:US
Mailing Address - Phone:704-575-5020
Mailing Address - Fax:
Practice Address - Street 1:2728 OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2445
Practice Address - Country:US
Practice Address - Phone:434-385-7818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001233010163W00000X
VA0024176780363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse