NPI Code Details Logo

NPI 1669860623

NPI 1669860623 : PATRICIA DIANE BUTLER RD, LDN, CDCES : RALEIGH, NC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1669860623
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    PATRICIA DIANE BUTLER RD, LDN, CDCES
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/29/2014
-----------------------------------------------------
    Last Update Date     |    10/30/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1709 SONESTA CT 
-----------------------------------------------------
    City                 |    RALEIGH
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    27613-8562
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    919-622-2174
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1709 SONESTA CT 
-----------------------------------------------------
    City                 |    RALEIGH
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    27613-8562
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    919-622-2175
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    133V00000X
-----------------------------------------------------
    Taxonomy Name        |    Registered Dietitian
-----------------------------------------------------
    License Number       |    L004281
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.