Provider Demographics
NPI:1033716634
Name:BUTLER, SARAH LYNNERAVEN PETTY (PA-C)
Entity Type:Individual
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First Name:SARAH
Middle Name:LYNNERAVEN PETTY
Last Name:BUTLER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2016 OSBOURNE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4776
Mailing Address - Country:US
Mailing Address - Phone:919-618-1534
Mailing Address - Fax:
Practice Address - Street 1:5838 SIX FORKS RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3893
Practice Address - Country:US
Practice Address - Phone:919-785-3400
Practice Address - Fax:919-783-7778
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2022-11-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical