Healthcare Provider Details

I. General information

NPI: 1538626213
Provider Name (Legal Business Name): EMILY BUTTARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W LEOTA ST STE 2
NORTH PLATTE NE
69101-6292
US

IV. Provider business mailing address

6114 4TH AVE APT 2
KEARNEY NE
68845-2826
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-2900
  • Fax:
Mailing address:
  • Phone: 801-645-3713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number112730
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: