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General NPI Number Information
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NPI Number | 1386468569
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Entity Type | Individual
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Provider Name | TABITHA BUTCHER FNP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 146 PINNELL ST
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City | RIPLEY
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State | WV
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Zip | 25271-9101
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Country | US
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Telephone | 304-373-1537
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Fax |
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Provider Business Mailing Address
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Address Line | 4959 EVANSVIEW RD
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City | EVANS
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State | WV
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Zip | 25241-8144
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Country | US
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Telephone | 304-373-4300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 109317
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 109317
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 109317
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License Number State | WV
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