Provider Demographics
NPI:1598322729
Name:BUTLER, NANCY YVETTE (LPN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:YVETTE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 BURNLEY SQ E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2661
Mailing Address - Country:US
Mailing Address - Phone:330-559-7935
Mailing Address - Fax:
Practice Address - Street 1:6116 BURNLEY SQ E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2661
Practice Address - Country:US
Practice Address - Phone:330-559-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152409164W00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse