Provider Demographics
NPI:1043540644
Name:BUTLER, TONI ELAINE (LPN)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:ELAINE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 EUGENE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-3311
Mailing Address - Country:US
Mailing Address - Phone:702-648-3479
Mailing Address - Fax:
Practice Address - Street 1:5757 WAYNE NEWTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89111-5000
Practice Address - Country:US
Practice Address - Phone:702-261-4463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLPN13372164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse