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General NPI Number Information
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NPI Number | 1407866031
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Entity Type | Individual
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Provider Name | SUSAN J BUTCHER APRN, CNS
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 10901 E 48TH ST
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City | TULSA
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State | OK
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Zip | 74146-5830
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Country | US
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Telephone | 918-749-8765
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Fax | 918-392-2155
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Provider Business Mailing Address
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Address Line | 10901 E 48TH ST
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City | TULSA
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State | OK
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Zip | 74146-5830
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Country | US
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Telephone | 918-749-8765
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Fax | 918-392-2155
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | R0042259
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License Number State | OK
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