Organization
PRACTITONERS COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEILA RENEE LITTLES DNP, NP (NURSE PRACTITIONER)
(770) 374-7062
Entity
Organization
Contact information
Practice address
870 CRESTMARK DR STE 200, LITHIA SPRINGS, GA 30122-2665
(770) 374-7062
Mailing address
870 CRESTMARK DR STE 200, LITHIA SPRINGS, GA 30122-2665
(770) 374-7062
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003227729B
—
GA
01
—
Q03882281
MEDICARE
GA
Enumeration date
09/17/2019
Last updated
07/18/2022
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