Provider Demographics
NPI:1023476207
Name:BUTLER, BRITTANY K (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:K
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 9
Mailing Address - Street 2:TRI-AREA COMMUNITY HEALTH
Mailing Address - City:LAUREL FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24352
Mailing Address - Country:US
Mailing Address - Phone:276-398-2292
Mailing Address - Fax:
Practice Address - Street 1:180 FERRUM MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FERRUM
Practice Address - State:VA
Practice Address - Zip Code:24088-2939
Practice Address - Country:US
Practice Address - Phone:540-365-4469
Practice Address - Fax:540-365-4272
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110005220363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1053442848Medicaid