Provider Demographics
NPI:1669489860
Name:BUTTERFIELD, KAREN (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11711 HIDDEN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9503
Mailing Address - Country:US
Mailing Address - Phone:502-412-4411
Mailing Address - Fax:
Practice Address - Street 1:1025 NEW MOODY LN
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9154
Practice Address - Country:US
Practice Address - Phone:502-222-3886
Practice Address - Fax:502-222-8647
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1037919/1884A 043092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000377949OtherANTHEM BCBS
KY74430927Medicaid
KY1135870Medicaid
000000188237OtherANTHEM BCBS
IN74430977Medicaid
000000198237OtherANTHEM MIDWEST
000000377949OtherANTHEM BCBS
IN0964301Medicare ID - Type UnspecifiedMEDICARE INDIANA
IN430064583Medicare ID - Type UnspecifiedMEDICARE IN/MED. RAILROAD
000000198237OtherANTHEM MIDWEST
KY1135870Medicaid
KY0964304Medicare ID - Type UnspecifiedMEDICARE KENTUCKY
IN430064683Medicare ID - Type UnspecifiedMED. IN/UNITED HEALTHCARE