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NPI Code Detail

MEDICARE: CATHY AURELIA BUTLER FNP

MEDICARE: CATHY AURELIA BUTLER FNP
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
1363L00000XNurse PractitionerRN179635GA

General Provider Information

NPI Number : 1649102195
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHY AURELIA BUTLER FNP
Provider Business Mailing Address
First Line : 768 ALCOVY MILL PARK
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30045-5900
Country : US
Telephone Number : 470-865-3776
Fax Number :
Provider Business Practice Location Address
First Line : 120 SAINT JOHNS COMMONS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32259-4057
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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