Provider Demographics
NPI:1093070286
Name:BUTTERFIELD, AUDREY MAE (RN)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:MAE
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 BORDEAUX LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3691
Mailing Address - Country:US
Mailing Address - Phone:513-505-5302
Mailing Address - Fax:
Practice Address - Street 1:4926 BORDEAUX LN
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3691
Practice Address - Country:US
Practice Address - Phone:513-505-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 232453163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse