Provider Demographics
NPI:1215232293
Name:BUTLER, CATHERINE A (FNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:BUTLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 DEBARR RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2959
Mailing Address - Country:US
Mailing Address - Phone:907-777-1800
Mailing Address - Fax:907-770-2341
Practice Address - Street 1:2925 DEBARR RD
Practice Address - Street 2:SUITE 230
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2959
Practice Address - Country:US
Practice Address - Phone:907-777-1800
Practice Address - Fax:907-770-2341
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1571318Medicaid