Provider Demographics
NPI:1760423115
Name:BUTORAC, ABIGAIL JOANNE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:JOANNE
Last Name:BUTORAC
Suffix:
Gender:F
Credentials:CRNA
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Other - Credentials:
Mailing Address - Street 1:110 29TH AVE N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1401
Mailing Address - Country:US
Mailing Address - Phone:615-327-4304
Mailing Address - Fax:615-327-7940
Practice Address - Street 1:110 29TH AVE N
Practice Address - Street 2:SUITE 202
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1401
Practice Address - Country:US
Practice Address - Phone:615-327-4304
Practice Address - Fax:615-327-7940
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN10592367500000X
TN10592208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008788Medicaid
TNQ008788Medicaid