GLENN M LITTLE JR. (NPI# 1396727152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396727152 |
| Entity Type | Individual |
| Full Name | GLENN M LITTLE JR. |
| Credential | PA |
| Practice Address |
2630 Central Ave Ste 1 Eielson Afb AK 99702-2301 |
| Practice Telephone | 9073776560 |
| Mailing Telephone | 9073776560 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2018-04-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2630 CENTRAL AVE STE 1 |
| City | EIELSON AFB |
| State | AK |
| Zip Code | 99702-2301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174864904 | Eric Noll | Optometrist | 2630 Central Ave # 3349, Eielson Afb, AK 99702 | 2013-03-04 |
| 1407125123 | Optical Center | Technician/Technologist | 451 Broadway Street, Eielson Afb Aafes Exchange, Eielson, AK 99702 | 2011-12-27 |
| 1063649234 | John Michael Strothenke | Military Health Care Provider | 2630 Central Avenue Suite 1, 354 Medical Operations Squadron, Clinical Medicine Flt, Eielson Air Force Base, AK 99702 | 2009-06-16 |
| 1225272073 | Landru Derek Medvec | Military Health Care Provider | 2422 Arctic Ave, Apt D, Eielson Afb, AK 99702 | 2009-04-23 |
| 1780875617 | Victoria L Ketchum | Specialist | E. Cowles, Fairbanks Memorial Hospital, Fairbanks, AK 99702 | 2007-08-06 |
| 1689768103 | Angie M. Walker | Social Worker | 2630 Central Av, Suite 1m07, Eielson Afb, AK 99702 | 2006-10-02 |
| 1306945464 | 354th Medical Group Mdg | Military/U.S. Coast Guard Pharmacy | Bldg 3349 Central Ave, Eielson Afb, AK 99702 | 2006-09-22 |
| 1760442297 | Susan Mary Runyan | Dietitian, Registered | 354th Medical Group, 2630 Central Ave, Suite 1m07, Eielson Afb, AK 99702 | 2006-03-27 |
| 1972166916 | Andrew Joseph Colburn | Registered Nurse | 2630 Central Ave # 3349, Eielson Afb, AK 99702 | 2019-04-16 |
| 1952885121 | Anthony Ewell-kollmann | Dentist | 2630 Central Ave, Eielson Afb, AK 99702 | 2018-09-24 |
| Find all providers in zip 99702 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164823241 | Adrian E Jones | Physician Assistant | 2630 Central Ave Bldg 3349, Eielson Afb, AK 99702-2301 | 2014-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517226 | Robin Lynn Morris | Physician Assistant | 3275 Togiak St, Kenai, AK 99611-8483 | 2020-10-27 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1043775414 | Brandon James Wilson | Physician Assistant | Uscg Base Kodiak Rockmore-king Clinic, 200 Albatross Ave Bldg N-46, Kodiak, AK 99615-6810 | 2019-02-09 |
| 1679056659 | Bennett Robert Stadler | Physician Assistant | 673 Mdg 5955 Zeamer Avenue, Jber, AK 99506 | 2018-09-14 |
| 1427539261 | Aimee Johnson | Physician Assistant | 1640 Cowles St Ste 1, Fairbanks, AK 99701-5908 | 2018-08-28 |
| 1801376702 | Matthew Gerard Somma | Physician Assistant | 1-25 Attack Reconnaissance Bn, Fort Wainwright, AK 99703 | 2018-08-20 |
| 1215443122 | Denali Surgical Services, LLC | Physician Assistant | 12110 Business Blvd Ste 6 #410, Eagle River, AK 99577-7798 | 2017-12-15 |
| 1497274419 | Pearl Margaret Churchill | Physician Assistant | Usibelli Spur Road, Healy, AK 99743 | 2017-09-11 |
| 1912426040 | Ashley Boge | Physician Assistant | 2925 Debarr Rd Ste D350, Anchorage, AK 99508-2959 | 2017-09-09 |
| 1215455597 | Leigha Henry-waugh | Physician Assistant | 3724 Lincoln Ellsworth Ct Unit B, Anchorage, AK 99517-2354 | 2017-09-06 |
| Find all providers with the same taxonomy | ||||
| City | EIELSON AFB |
| Zip Code | 99702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.