Provider Demographics
NPI:1205550183
Name:BUTLER, LITISHA
Entity type:Individual
Prefix:
First Name:LITISHA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 CROSSWAYS BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0218
Mailing Address - Country:US
Mailing Address - Phone:757-777-3595
Mailing Address - Fax:888-510-7098
Practice Address - Street 1:1545 CROSSWAYS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0218
Practice Address - Country:US
Practice Address - Phone:757-777-3595
Practice Address - Fax:888-510-7098
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant