MEDICARE: ERICA LEIGH BUTLER RDN, LD

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	133V00000X	Registered Dietitian	L003480	NC

General Provider Information

NPI Number	:	1407170780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LEIGH BUTLER RDN, LD

Provider Business Mailing Address
First Line	:	5202 BETHEL REED PARK STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1818
Country	:	US
Telephone Number	:	614-664-3646
Fax Number	:	614-987-8654

Provider Business Practice Location Address
First Line	:	5202 BETHEL REED PARK STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1818
Country	:	US
Telephone Number	:	614-664-3646
Fax Number	:	614-987-8654

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

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	02/06/2024

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