Individual
SHELBY M. LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2013027650
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669804845
—
MO
05
—
199442001
—
AR
01
—
431560263
TRICARE
MO
01
—
P01235240
RR MCR
MO
Enumeration date
07/30/2013
Last updated
01/03/2014
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