MEDICARE: EMILY KATHLEEN BUTTIL BSN, RN

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	163W00000X	Registered Nurse	RN605190	PA

General Provider Information

NPI Number	:	1285964817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY KATHLEEN BUTTIL BSN, RN

Provider Business Mailing Address
First Line	:	5902 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-1824
Country	:	US
Telephone Number	:	215-276-5500
Fax Number	:	267-773-4430

Provider Business Practice Location Address
First Line	:	5902 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-1824
Country	:	US
Telephone Number	:	215-276-5500
Fax Number	:	267-773-4430

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

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	01/04/2010

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