MEDICARE: MRS. VALERIE ANNE BUTLER R.N.

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	163WS0200X	School Registered Nurse	490258-1	NY

General Provider Information

NPI Number	:	1326315144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALERIE ANNE BUTLER R.N.

Provider Business Mailing Address
First Line	:	108 OAK ST
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-1693
Country	:	US
Telephone Number	:	518-561-4760
Fax Number	:	518-561-5828

Provider Business Practice Location Address
First Line	:	108 OAK ST
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-1693
Country	:	US
Telephone Number	:	518-561-4760
Fax Number	:	518-561-5828

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

Provider Enumeration Date	:	11/22/2011
Last Update Date	:	11/22/2011

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