MEDICARE: JULIE LYNNE BUTLER AGACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	0024173527	VA

General Provider Information

NPI Number	:	1538825674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE LYNNE BUTLER AGACNP-BC

Provider Business Mailing Address
First Line	:	8507 CYRUS PL
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-2014
Country	:	US
Telephone Number	:	805-302-4035
Fax Number	:

Provider Business Practice Location Address
First Line	:	8507 CYRUS PL
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-2014
Country	:	US
Telephone Number	:	805-302-4035
Fax Number	:

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

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	11/12/2021

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