Individual
JASMINE CHEYENNE BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893
(252) 399-8040
(252) 399-8778
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06162
NC
Other
Enumeration date
12/17/2015
Last updated
08/22/2019
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