Individual
THERESA R LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 522-4880
(864) 522-4885
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
820
SC
363AM0700X
Medical Physician Assistant
A820
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085PA
—
SC
01
—
P00802359
RR MEDICARE
SC
Enumeration date
05/20/2006
Last updated
09/24/2025
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