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General NPI Number Information
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NPI Number | 1962736397
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Entity Type | Individual
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Provider Name | JENNNIFER T BUTLER RN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 6990 STATE ROUTE 95
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City | FREDERICKTOWN
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State | OH
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Zip | 43019-9556
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Country | US
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Telephone | 740-501-8948
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Fax |
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Provider Business Mailing Address
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Address Line | 6990 STATE ROUTE 95
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City | FREDERICKTOWN
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State | OH
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Zip | 43019-9556
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Country | US
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Telephone | 740-501-8948
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN 124429 IV
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.373921-
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License Number State | OH
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