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General NPI Number Information
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NPI Number | 1548249782
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Entity Type | Individual
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Provider Name | JOELLEN HEGG BUTLER PSY NURSE PRACTITION
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Gender | Female
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 06/19/2021
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Provider Practice Location Address
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Address Line | 9159 S GRANDVIEW DR
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City | TEMPE
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State | AZ
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Zip | 85284-3141
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Country | US
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Telephone | 480-787-9384
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Fax | 480-940-3922
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Provider Business Mailing Address
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Address Line | 9159 S GRANDVIEW DR
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City | TEMPE
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State | AZ
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Zip | 85284-3141
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Country | US
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Telephone | 480-787-9384
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Fax | 480-940-3922
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN083932
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN083932
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP6062
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License Number State | AZ
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