Provider Demographics
NPI:1255947065
Name:NUTTER, DON WILLIAM
Entity type:Individual
Prefix:
First Name:DON
Middle Name:WILLIAM
Last Name:NUTTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5302 QUINWOOD NUTTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NALLEN
Mailing Address - State:WV
Mailing Address - Zip Code:26680-6809
Mailing Address - Country:US
Mailing Address - Phone:304-661-8164
Mailing Address - Fax:
Practice Address - Street 1:5302 QUINWOOD NUTTERVILLE RD
Practice Address - Street 2:
Practice Address - City:NALLEN
Practice Address - State:WV
Practice Address - Zip Code:26680-6809
Practice Address - Country:US
Practice Address - Phone:304-661-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant