Provider Demographics
NPI:1134002447
Name:LITTLE, SHELLEY SIMS
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:SIMS
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 LOWER BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-9689
Mailing Address - Country:US
Mailing Address - Phone:865-228-3393
Mailing Address - Fax:
Practice Address - Street 1:535 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-2536
Practice Address - Country:US
Practice Address - Phone:731-989-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist