Provider Demographics
NPI:1972687226
Name:LITTLE, CHERYL RENEE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:RENEE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:17 ROCKY RD
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9158
Mailing Address - Country:US
Mailing Address - Phone:606-886-3551
Mailing Address - Fax:606-889-9404
Practice Address - Street 1:5291 KENTUCKY ROUTE 321
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653
Practice Address - Country:US
Practice Address - Phone:606-889-9003
Practice Address - Fax:606-889-9404
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist