Provider Demographics
NPI:1508283391
Name:BUTTS, FERA KRISTINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:FERA
Middle Name:KRISTINE
Last Name:BUTTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 MAPLETON CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-5282
Mailing Address - Country:US
Mailing Address - Phone:303-947-3885
Mailing Address - Fax:
Practice Address - Street 1:855 MAPLETON CT
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-5282
Practice Address - Country:US
Practice Address - Phone:303-947-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO124243163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse