Phyllis K Butler, FNP

Individual provider Active NPI Family Nurse Practitioner · Mariposa, CA

NPI 1508921487 · NPPES record last updated Sep 25, 2014

Key facts

NPI
1508921487
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
0073142-22 (CA)
Practice address
5300 Hwy 49 N.
Mariposa, CA 95338
Phone
(209) 966-3672
Fax
(209) 966-5548
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0073142-22CAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0073142-22 CA Yes

Addresses

Primary practice location

5300 Hwy 49 N.
Mariposa, CA 95338

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 725-7149

Other identifiers

IdentifierTypeStateIssuer
211026OtherCARN#

Other providers in Mariposa, CA

All providers in Mariposa, CA · Family Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.