Provider Demographics
NPI:1952803041
Name:BUTCHER, DEANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:
Other - Last Name:JOHNSON-BUTCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3015 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1114
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:3015 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1114
Practice Address - Country:US
Practice Address - Phone:610-202-3207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily