Individual
MRS. DAVINA I LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2820 OHIO ST, AUGUSTA, KS 67010-2361
(316) 775-7500
(316) 775-3685
Mailing address
2820 OHIO ST, AUGUSTA, KS 67010-2361
(316) 775-7500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-79586
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102644
GRP PTAN
KS
01
—
102644010
IND PTAN
KS
01
—
1891730339
GRP NPI
KS
01
—
1902412117
IND NPI
KS
01
—
27-0040297
TAX ID
KS
05
—
30003885870001
—
KS
05
—
30004720490001
—
KS
Enumeration date
09/22/2020
Last updated
10/28/2024
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