Provider Demographics
NPI:1316796840
Name:BUTCHER, PEYTON RAE
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:RAE
Last Name:BUTCHER
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 1:250 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-1503
Mailing Address - Country:US
Mailing Address - Phone:304-919-9222
Mailing Address - Fax:
Practice Address - Street 1:250 ARCH ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-1503
Practice Address - Country:US
Practice Address - Phone:304-919-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant