MEDICARE: MS. ANN MARIE BUTTERWORTH CRNP

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	363L00000X	Nurse Practitioner	R082382	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	138CSE-60656501	OTHER	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	T016-0028	OTHER	BCBS-DC
5	0943ER-606565-02	OTHER	CAREFIRST BCBS OF MD
6	138CER-606565-01	OTHER	CAREFIRST BCBS OF MD
7	60656501	OTHER	EVERCARE

General Provider Information

NPI Number	:	1316937329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN MARIE BUTTERWORTH CRNP

Provider Business Mailing Address
First Line	:	5525 RESEARCH PARK DR FL 4
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-4873
Country	:	US
Telephone Number	:	410-247-5602
Fax Number	:	410-242-1756

Provider Business Practice Location Address
First Line	:	711 MAIDEN CHOICE LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-3632
Country	:	US
Telephone Number	:	410-247-5602
Fax Number	:	410-242-1756

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	12/05/2014

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