Provider Demographics
NPI:1609128651
Name:BUTLER, LAUREN A (CNM)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:BUTLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22573
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2573
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-651-0794
Practice Address - Street 1:2401 E EVESHAM RD
Practice Address - Street 2:STE A
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9590
Practice Address - Country:US
Practice Address - Phone:856-424-3323
Practice Address - Fax:856-424-4994
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00051601367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife