Provider Demographics
NPI:1639355597
Name:BUTLER, ALLISON KIME (NP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:KIME
Last Name:BUTLER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 KINGS WAY
Practice Address - Street 2:SUITE 3400
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2505
Practice Address - Country:US
Practice Address - Phone:757-253-5600
Practice Address - Fax:757-253-0819
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2013-09-30
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Provider Licenses
StateLicense IDTaxonomies
VA0024107050363LX0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1639355597Medicaid