Provider Demographics
NPI:1790918464
Name:BUTLER, MARLA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:ANN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E MANSFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-1938
Mailing Address - Country:US
Mailing Address - Phone:419-689-6744
Mailing Address - Fax:
Practice Address - Street 1:921 E MANSFIELD ST
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-1938
Practice Address - Country:US
Practice Address - Phone:419-689-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 258031163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse