Provider Demographics
NPI:1447649942
Name:LITTLE, BRANDIE
Entity type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MEDICAL CENTER DR, 4648 TVC
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232
Mailing Address - Country:US
Mailing Address - Phone:615-343-6336
Mailing Address - Fax:615-343-1966
Practice Address - Street 1:1301 MEDICAL CENTER DR
Practice Address - Street 2:4648 TVC
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0028
Practice Address - Country:US
Practice Address - Phone:615-343-6336
Practice Address - Fax:615-343-1966
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104098367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered