Healthcare Provider Details

I. General information

NPI: 1225189756
Provider Name (Legal Business Name): DONNA LOUISE BUTTS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11525 BROOKSHIRE AVE ATTN MAGGIE NOLES
DOWNEY CA
90241-4985
US

IV. Provider business mailing address

22603 ANZA AVE
TORRANCE CA
90505-3418
US

V. Phone/Fax

Practice location:
  • Phone: 562-741-4461
  • Fax: 562-741-4413
Mailing address:
  • Phone: 310-378-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR.N. 537716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: