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General NPI Number Information
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NPI Number | 1487506655
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Entity Type | Individual
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Provider Name | JOHNNA TATE BUTLER CHC
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Gender | Female
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 614 PACTOLAS RD
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City | JOHNSON CITY
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State | TN
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Zip | 37604-4426
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Country | US
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Telephone | 662-671-9057
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Fax |
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Provider Business Mailing Address
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Address Line | 614 PACTOLAS RD
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City | JOHNSON CITY
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State | TN
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Zip | 37604-4426
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Country | US
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Telephone | 662-671-9057
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | TN
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