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NPI Code Detail

MEDICARE: MRS. WHITNEY NYCOLE BUTLER MS, OTR/L

MEDICARE: MRS. WHITNEY NYCOLE BUTLER MS, OTR/L
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
1225X00000XOccupational Therapist0119006845VA
2225XP0200XPediatric Occupational Therapist5341TN
3225X00000XOccupational Therapist5341TN

General Provider Information

NPI Number : 1922452127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. WHITNEY NYCOLE BUTLER MS, OTR/L
Provider Business Mailing Address
First Line : 2214 E FAIRVIEW AVE
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2860
Country : US
Telephone Number : 423-928-6464
Fax Number : 423-232-7970
Provider Business Practice Location Address
First Line : 2214 E FAIRVIEW AVE
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2860
Country : US
Telephone Number : 423-928-6464
Fax Number : 423-232-7970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 09/05/2023

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