Provider Demographics
NPI:1891422051
Name:BUTCHER, PAMELA (BIRTH DOULA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 USS ARIZONA LN APT 6
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-5069
Mailing Address - Country:US
Mailing Address - Phone:317-504-7683
Mailing Address - Fax:
Practice Address - Street 1:431 USS ARIZONA LN APT 6
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-5069
Practice Address - Country:US
Practice Address - Phone:317-504-7683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3816374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula