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General NPI Number Information
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NPI Number | 1114026630
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Entity Type | Individual
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Provider Name | SHELLEY DENISE BUTLER LVN
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10300 COMPTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90002-3628
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Country | US
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Telephone | 323-568-3006
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Fax | 323-568-3384
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Provider Business Mailing Address
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Address Line | 9222 S MANHATTAN PL
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City | LOS ANGELES
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State | CA
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Zip | 90047-3845
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Country | US
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Telephone | 323-242-2167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN137394
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License Number State | CA
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