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NPI Code Detail

MEDICARE: AMANDA BUTLER

MEDICARE: AMANDA BUTLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner5022139NC

General Provider Information

NPI Number : 1043009418
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA BUTLER
Provider Business Mailing Address
First Line : PO BOX 751069
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1069
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 252-847-4378
Fax Number : 252-847-9943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2025
Last Update Date : 03/10/2026

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