Doctor Name: | MRS. PHYLLIS K BUTLER |
NPI Number: | 1508921487 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 0073142-22 |
Business Practice Address: | 5300 Hwy 49 N. Mariposa, CA - 95338 |
Business Phone Number: | 2099663672 |
Business Fax Number: | 2099665548 |
Mailing Address: | Po Box 3768, MERCED |
State: | CA |
Postal Code: | 953443768 |
Phone Number: | 2097257149 |
Fax Number: | 2097260134 |
NPI Enumeration Date: | 12/22/2006 |
NPI Last Update Date: | 09/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0073142-22 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |