Healthcare Provider Details

I. General information

NPI: 1831701572
Provider Name (Legal Business Name): JILLIAN LEIGH BUTCHER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2020
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S LIMESTONE # A414
LEXINGTON KY
40508-3008
US

IV. Provider business mailing address

PO BOX 936
LONDON KY
40743-0936
US

V. Phone/Fax

Practice location:
  • Phone: 859-226-7006
  • Fax: 859-226-7008
Mailing address:
  • Phone:
  • Fax: 606-330-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3014837
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: