Gerald Little, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Tacoma, WA

NPI 1750320396 · NPPES record last updated Apr 1, 2008

Key facts

NPI
1750320396
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
AP30007357 (WA)
Practice address
9600 Veterans Drive
Tacoma, WA 98493-0001
Phone
(253) 582-8440
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200424002375 TX Order and Referring Only - Nurse Practitioner 4486692407

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FMC Medical Foundation, Inc Family Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30007357 WA Yes

Addresses

Primary practice location

9600 Veterans Drive
Tacoma, WA 98493-0001

Mailing address

9600 Veterans Drive
Tacoma, WA 98493-0001
Phone (253) 582-8440

Other providers in Tacoma, WA

All providers in Tacoma, WA · Family Nurse Practitioner in Washington

Sources for this page

Verify at the official NPI Registry.