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General NPI Number Information
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NPI Number | 1275968489
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Entity Type | Individual
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Provider Name | AMY RENEE BUTLER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 980 EXECUTIVE DR STE D
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City | OSAGE BEACH
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State | MO
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Zip | 65065-3495
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Country | US
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Telephone | 573-746-5474
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Fax | 573-746-5475
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Provider Business Mailing Address
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Address Line | 980 EXECUTIVE DR STE D
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City | OSAGE BEACH
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State | MO
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Zip | 65065-3495
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Country | US
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Telephone | 573-746-5474
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Fax | 737-465-4755
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2013033428
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License Number State | MO
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