Provider Demographics
NPI:1780407775
Name:BUTLER, ALETHEA MICHELLE (NURSE PRACTIONER)
Entity type:Individual
Prefix:
First Name:ALETHEA
Middle Name:MICHELLE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 BUTLERS AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:VA
Mailing Address - Zip Code:22503-2901
Mailing Address - Country:US
Mailing Address - Phone:804-761-1332
Mailing Address - Fax:
Practice Address - Street 1:9891 GENERAL PULLER HWY
Practice Address - Street 2:
Practice Address - City:HARTFIELD
Practice Address - State:VA
Practice Address - Zip Code:23071-3122
Practice Address - Country:US
Practice Address - Phone:804-776-9221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024190925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily