MEDICARE: HAILEY BUTENHOFF

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1205790870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAILEY BUTENHOFF

Provider Business Mailing Address
First Line	:	908 WINDSOR ST
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-2023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 WINDSOR ST
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-2023
Country	:	US
Telephone Number	:	414-249-4420
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ HAILEY BUTENHOFF ” Practice Location

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