Provider Demographics
NPI:1831981802
Name:WITCHER, COURTNEY PAIGE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:PAIGE
Last Name:WITCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-3208
Mailing Address - Country:US
Mailing Address - Phone:540-676-6494
Mailing Address - Fax:
Practice Address - Street 1:1111 NEWMAN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4030
Practice Address - Country:US
Practice Address - Phone:540-676-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant