Provider Demographics
NPI:1104191113
Name:BUTTERWORTH, JAMIE (ARNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BUTTERWORTH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-222-7000
Mailing Address - Fax:515-222-7037
Practice Address - Street 1:1601 NW 114TH ST.
Practice Address - Street 2:SUITE: 245
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7036
Practice Address - Country:US
Practice Address - Phone:515-222-7000
Practice Address - Fax:515-222-7037
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA106746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily