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NPI Code Detail

MEDICARE: MRS. JENNIFER LYNNE BUTLER LPN

MEDICARE:  MRS. JENNIFER LYNNE BUTLER  LPN
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
1164W00000XLicensed Practical NurseLP043742AZ

General Provider Information

NPI Number : 1972737823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LYNNE BUTLER LPN
Provider Business Mailing Address
First Line : 12807 W ASH ST
Second Line :
City : EL MIRAGE
State : AZ
Zip : 85335-6273
Country : US
Telephone Number : 623-933-0257
Fax Number :
Provider Business Practice Location Address
First Line : 12807 W ASH ST
Second Line :
City : EL MIRAGE
State : AZ
Zip : 85335-6273
Country : US
Telephone Number : 623-933-0257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2009
Last Update Date : 05/06/2009

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Directions to “ MRS. JENNIFER LYNNE BUTLER LPN” Practice Location

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