Healthcare Provider Details

I. General information

NPI: 1245150325
Provider Name (Legal Business Name): RITA ANN BUTLER RN, P&IC DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38710 LAURENWOOD ST
WAYNE MI
48184-1033
US

IV. Provider business mailing address

38710 LAURENWOOD ST
WAYNE MI
48184-1033
US

V. Phone/Fax

Practice location:
  • Phone: 734-765-9820
  • Fax:
Mailing address:
  • Phone: 734-765-9820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number4704159685
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: