Provider Demographics
NPI:1538523790
Name:LITTLE, REBECCA A (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:LITTLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-5810
Mailing Address - Country:US
Mailing Address - Phone:606-886-0224
Mailing Address - Fax:
Practice Address - Street 1:59 THACKER RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3021
Practice Address - Country:US
Practice Address - Phone:606-552-0400
Practice Address - Fax:606-284-6310
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010140363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100395870Medicaid