Provider Demographics
NPI:1265207286
Name:LITTLE, TRISH DANIELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRISH
Middle Name:DANIELLE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3700
Mailing Address - Country:US
Mailing Address - Phone:918-298-4428
Mailing Address - Fax:918-298-4460
Practice Address - Street 1:511 S ELM ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3700
Practice Address - Country:US
Practice Address - Phone:918-298-4428
Practice Address - Fax:918-298-4460
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66790183500000X
OK14919183500000X
AL15502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist