| Organization Name: | LITTLE CLINIC OF VA LLC |
| NPI Number: | 1225440076 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH W PATRIC (CHIEF LEGAL OFFICER) |
| Mailing Address: | 9000 Staples Mill Rd Henrico |
| State: | VA US |
| Postal Code: | 232282021 |
| Phone Number: | 8049779526 |
| Fax Number: | |
| NPI Enumeration Date: | 05/28/2014 |
| NPI Last Update Date: | 10/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |