Provider Demographics
NPI:1831263490
Name:LITTLE, JODI ANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ANNE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:ANNE
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5889
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:1111 W 34TH ST
Practice Address - Street 2:STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1900
Practice Address - Country:US
Practice Address - Phone:512-454-4588
Practice Address - Fax:512-459-9869
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX748433163W00000X
TXAP116478363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse