MEDICARE: TONI ELAINE BUTLER LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN13372	NV

General Provider Information

NPI Number	:	1043540644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI ELAINE BUTLER LPN

Provider Business Mailing Address
First Line	:	6236 EUGENE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-3311
Country	:	US
Telephone Number	:	702-648-3479
Fax Number	:

Provider Business Practice Location Address
First Line	:	5757 WAYNE NEWTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89111-5000
Country	:	US
Telephone Number	:	702-261-4463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	01/04/2010

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Directions to “ TONI ELAINE BUTLER LPN” Practice Location

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