Provider Demographics
NPI:1407968936
Name:HAYDON BUTTNER, MARIA (APN C)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:HAYDON BUTTNER
Suffix:
Gender:F
Credentials:APN C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 FAR VIEW RD
Mailing Address - Street 2:
Mailing Address - City:GREAT MEADOWS
Mailing Address - State:NJ
Mailing Address - Zip Code:07838-2701
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:11 CENTRE STREET
Practice Address - Street 2:THEATRE CENTER
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN099169363LF0000X
NJ26NN09916900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8574201Medicaid
NJ020004XVAMedicare PIN
NJ8574201Medicaid
NJ020004Medicare ID - Type Unspecified