Provider Demographics
NPI:1407636830
Name:BOUTTON, CHLOE (PA-C)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:BOUTTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3770
Mailing Address - Country:US
Mailing Address - Phone:412-267-6600
Mailing Address - Fax:412-267-6281
Practice Address - Street 1:575 COAL VALLEY RD STE 300
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3770
Practice Address - Country:US
Practice Address - Phone:412-267-6600
Practice Address - Fax:412-267-6281
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA006685363AM0700X
PAMA065076363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical