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Organization

LITTLE CLINIC OF VA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS SHELLY (VP & GENERAL MANAGER)
(615) 425-4200
Entity
Organization

Contact information

Practice address
9000 STAPLES MILL RD, HENRICO, VA 23228-2021
(804) 977-9526
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
(615) 425-4200
(615) 891-5244

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2014212603
VA
Enumeration date
05/28/2014
Last updated
10/22/2025
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