Healthcare Provider Details

I. General information

NPI: 1609128651
Provider Name (Legal Business Name): LAUREN A BUTLER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E EVESHAM RD STE A
VOORHEES NJ
08043-9590
US

IV. Provider business mailing address

PO BOX 22573
NEW YORK NY
10087-2573
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-3323
  • Fax: 856-424-4994
Mailing address:
  • Phone: 856-669-6050
  • Fax: 856-651-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00051601
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: