Provider Demographics
NPI:1497573703
Name:JONES-BUTTRAM, DOTTIE LOU (HOME HEALTH AGENCY)
Entity type:Individual
Prefix:
First Name:DOTTIE
Middle Name:LOU
Last Name:JONES-BUTTRAM
Suffix:
Gender:F
Credentials:HOME HEALTH AGENCY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 BELL CT
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8636
Mailing Address - Country:US
Mailing Address - Phone:919-922-5804
Mailing Address - Fax:919-324-1982
Practice Address - Street 1:708 BELL CT
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-8636
Practice Address - Country:US
Practice Address - Phone:919-922-5804
Practice Address - Fax:919-324-1982
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health