Provider Demographics
NPI:1497524144
Name:BUTLER, CATHARINE (LDEM)
Entity Type:Individual
Prefix:
First Name:CATHARINE
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 N 200 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1318
Mailing Address - Country:US
Mailing Address - Phone:435-650-0823
Mailing Address - Fax:
Practice Address - Street 1:1517 W GUN SMOKE DR
Practice Address - Street 2:
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065-5187
Practice Address - Country:US
Practice Address - Phone:801-900-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13037162-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife