Provider Demographics
NPI:1164643045
Name:BUTTON, EMILEY (APRN)
Entity Type:Individual
Prefix:
First Name:EMILEY
Middle Name:
Last Name:BUTTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1759
Mailing Address - Country:US
Mailing Address - Phone:270-781-6477
Mailing Address - Fax:270-647-6479
Practice Address - Street 1:5575 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-7826
Practice Address - Country:US
Practice Address - Phone:270-781-6477
Practice Address - Fax:270-647-6479
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78010840Medicaid
KY000000380463OtherBCBS
KY0956102Medicare ID - Type Unspecified
KY000000380463OtherANTHEM