Provider Demographics
NPI:1184629404
Name:BUTTS, AMY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:BUTTS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 COMMERCE STREET
Mailing Address - Street 2:
Mailing Address - City:WELLSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26070
Mailing Address - Country:US
Mailing Address - Phone:304-737-0816
Mailing Address - Fax:304-737-4338
Practice Address - Street 1:1423 COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:WELLSBURG
Practice Address - State:WV
Practice Address - Zip Code:26070
Practice Address - Country:US
Practice Address - Phone:304-737-0816
Practice Address - Fax:304-737-4338
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV881363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0343697Medicaid