Colleen Megan Butler

Individual provider Active NPI Licensed Practical Nurse · Pittsford, NY

NPI 1669950010 · NPPES record last updated Jul 29, 2018

Key facts

NPI
1669950010
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
326939 (NY)
Practice address
184 Park Rd
Pittsford, NY 14534-9740
Phone
(585) 507-2093
NPI assigned
Jul 29, 2018
Sex
Female
Sole proprietor
Yes

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
326939NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 326939 NY Yes

Addresses

Primary practice location

184 Park Rd
Pittsford, NY 14534-9740

Mailing address

184 Park Rd
Pittsford, NY 14534-9740
Phone (585) 507-2093

Other providers in Pittsford, NY

All providers in Pittsford, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.