MEDICARE: MISS LANA MAY BUTCHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1003842196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LANA MAY BUTCHER

Provider Business Mailing Address
First Line	:	PO BOX 7357
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44705-0357
Country	:	US
Telephone Number	:	330-371-2325
Fax Number	:

Provider Business Practice Location Address
First Line	:	1219 LIPPERT RD NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44705-1019
Country	:	US
Telephone Number	:	330-371-2325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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Directions to “ MISS LANA MAY BUTCHER ” Practice Location

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