Provider Demographics
NPI:1669029427
Name:BUTLER, BRIDGETT HOWELL (RD)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:HOWELL
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 REBEL CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2020
Mailing Address - Country:US
Mailing Address - Phone:615-587-9850
Mailing Address - Fax:
Practice Address - Street 1:4321 CAROTHERS PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5909
Practice Address - Country:US
Practice Address - Phone:615-435-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86040386133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered