Individual
MRS. JENNA MARIE LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 CHASE PKWY, SUITE 2B, WATERBURY, CT 06708-3346
(203) 755-6677
(203) 755-7166
Mailing address
1300 HORIZON DR, STE 101, CHALFONT, PA 18914-3970
(215) 489-9170
(215) 489-9174
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.002600
OH
363AS0400X
Surgical Physician Assistant
Primary
003290
CT
363AS0400X
Surgical Physician Assistant
50.002600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003290
CONNECTICUT LICENSE
CT
Enumeration date
08/28/2007
Last updated
09/01/2017
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