Provider Demographics
NPI:1588347983
Name:BUTLER, JOYCE ANN
Entity type:Individual
Prefix:MISS
First Name:JOYCE
Middle Name:ANN
Last Name:BUTLER
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 1:4115 WESTMORLAND CIR APT 233
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7886
Mailing Address - Country:US
Mailing Address - Phone:757-303-5158
Mailing Address - Fax:540-693-1641
Practice Address - Street 1:4115 WESTMORLAND CIR APT 233
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7886
Practice Address - Country:US
Practice Address - Phone:757-303-5158
Practice Address - Fax:540-693-1641
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
VAA60303092343900000X, 172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver