Healthcare Provider Details

I. General information

NPI: 1396659538
Provider Name (Legal Business Name): SABRINA BUTCHER CCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 N SAWMILL RD
AVOCA IA
51521
US

IV. Provider business mailing address

755 S CEDAR ST
AVOCA IA
51521-4031
US

V. Phone/Fax

Practice location:
  • Phone: 712-343-2424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberPARA4000142
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: