Jennnifer T Butler, RN

Individual provider Active NPI Registered Nurse · Fredericktown, OH

NPI 1962736397 · NPPES record last updated Apr 12, 2012

Key facts

NPI
1962736397
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN.373921- (OH)
Practice address
6990 State Route 95
Fredericktown, OH 43019-9556
Phone
(740) 501-8948
NPI assigned
Oct 2, 2009
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.373921-OHMDRegistered Nurse
PN 124429 IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 124429 IV OH
Registered Nurse 163W00000X RN.373921- OH Yes

Addresses

Primary practice location

6990 State Route 95
Fredericktown, OH 43019-9556

Mailing address

6990 State Route 95
Fredericktown, OH 43019-9556
Phone (740) 501-8948

Other providers in Fredericktown, OH

All providers in Fredericktown, OH · Registered Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.