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NPI Code Detail

MEDICARE: JANA SUE BUTCHER ARNP

MEDICARE: JANA SUE BUTCHER ARNP
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
1363LP0200XPediatric Nurse PractitionerR0029827OK

General Provider Information

NPI Number : 1194799833
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANA SUE BUTCHER ARNP
Provider Business Mailing Address
First Line : 13505 FOX CREEK DR
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73131-1279
Country : US
Telephone Number : 405-478-5789
Fax Number : 405-271-6865
Provider Business Practice Location Address
First Line : 1200 N PHILLIPS AVE
Second Line : SUITE 6100
City : OKLAHOMA CITY
State : OK
Zip : 73104-4600
Country : US
Telephone Number : 405-271-6827
Fax Number : 405-271-4418
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 01/24/2011

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