Provider Demographics
NPI:1366982704
Name:LITTLE, JENNIFER BARRETT (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BARRETT
Last Name:LITTLE
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1365 WEST BRIERBROOK ROAD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN- TENNESSEE
Mailing Address - Zip Code:38138
Mailing Address - Country:UM
Mailing Address - Phone:901-624-6517
Mailing Address - Fax:901-624-6521
Practice Address - Street 1:146 TIMBER CREEK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4395
Practice Address - Country:US
Practice Address - Phone:901-751-4112
Practice Address - Fax:901-751-9878
Is Sole Proprietor?:No
Enumeration Date:2017-03-05
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS901839363LF0000X
TNAPN0000022253363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily