Provider Demographics
NPI:1245064583
Name:GARCIA, LITTLE MARTINA (LPN)
Entity type:Individual
Prefix:
First Name:LITTLE
Middle Name:MARTINA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 7TH AVE APT A201
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-3680
Mailing Address - Country:US
Mailing Address - Phone:919-614-9219
Mailing Address - Fax:
Practice Address - Street 1:6118 SAINT GILES ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7082
Practice Address - Country:US
Practice Address - Phone:844-857-9942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95302164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse