Provider Demographics
NPI:1144226994
Name:BUTTERFIELD, JENNETTE V (NPP)
Entity Type:Individual
Prefix:
First Name:JENNETTE
Middle Name:V
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3655
Mailing Address - Country:US
Mailing Address - Phone:401-467-6257
Mailing Address - Fax:401-785-1191
Practice Address - Street 1:215 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4458
Practice Address - Country:US
Practice Address - Phone:401-739-7345
Practice Address - Fax:401-739-5733
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP037166163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9023939Medicaid
RI9023939Medicaid
509023939Medicare ID - Type Unspecified