MEDICARE: MS. ELLEN J BUTTS RN, APNP

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	363LW0102X	Women's Health Nurse Practitioner	218-033	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528001005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELLEN J BUTTS RN, APNP

Provider Business Mailing Address
First Line	:	N1550 770TH ST
Second Line	:
City	:	HAGER CITY
State	:	WI
Zip	:	54014-8027
Country	:	US
Telephone Number	:	715-792-2898
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 LEWIS ST
Second Line	:
City	:	RIVER FALLS
State	:	WI
Zip	:	54022-2107
Country	:	US
Telephone Number	:	715-425-8003
Fax Number	:	715-425-8221

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/09/2007

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