MEDICARE: ARIANNA BACON BUTCHER

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
1	171100000X	Acupuncturist	0121001234	VA

General Provider Information

NPI Number	:	1417541210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANNA BACON BUTCHER

Provider Business Mailing Address
First Line	:	300 S WASHINGTON ST STE 202
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5403
Country	:	US
Telephone Number	:	301-485-6226
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S WASHINGTON ST STE 202
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5403
Country	:	US
Telephone Number	:	301-485-6226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	05/09/2026

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