Provider Demographics
NPI:1194871715
Name:LITTLE, AMY MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
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 1393
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145-1393
Mailing Address - Country:US
Mailing Address - Phone:206-954-9554
Mailing Address - Fax:
Practice Address - Street 1:TAHOE FOREST HOSPITAL DISTRICT
Practice Address - Street 2:10121 PINE AVE.
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161
Practice Address - Country:US
Practice Address - Phone:530-582-3219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00049418207P00000X
NY242874-1207P00000X
CAC183327207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine