Provider Demographics
NPI:1316138209
Name:LITTLE, BARBARA (MSN NURSE)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MSN NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4025 LAWRENCEVILLE HWY NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2819
Mailing Address - Country:US
Mailing Address - Phone:770-921-7007
Mailing Address - Fax:770-921-7073
Practice Address - Street 1:4025 LAWRENCEVILLE HWY NW
Practice Address - Street 2:SUITE A
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2819
Practice Address - Country:US
Practice Address - Phone:770-921-7007
Practice Address - Fax:770-921-7073
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN094929364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health