Individual
MR. KEVIN THOMAS LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1466 LINCOLN AVE, SAN RAFAEL, CA 94901-2021
(925) 708-9328
Mailing address
1134 BUSH ST, MARTINEZ, CA 94553-2712
(925) 708-9328
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
546706
CA
363L00000X
Nurse Practitioner
Primary
11746
CA
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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