Provider Demographics
NPI:1508499617
Name:BUTTELL, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BUTTELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:OTLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50214-8529
Mailing Address - Country:US
Mailing Address - Phone:515-971-9404
Mailing Address - Fax:
Practice Address - Street 1:1200 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARITON
Practice Address - State:IA
Practice Address - Zip Code:50049-1210
Practice Address - Country:US
Practice Address - Phone:641-774-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111661363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant