Individual
KAVEENA JULISA LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4417 N 6TH ST, PHILADELPHIA, PA 19140-2319
(215) 302-3600
Mailing address
4417 N 6TH ST, PHILADELPHIA, PA 19140-2319
(215) 302-3600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
RTO000394
PA
363A00000X
Physician Assistant
C5-0012037
DE
363A00000X
Physician Assistant
Primary
MA064250
PA
Other
Enumeration date
12/01/2022
Last updated
03/29/2024
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