Provider Demographics
NPI:1942453980
Name:BUTLER, BRENDA A
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:A
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 HINSON LOOP RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3900
Mailing Address - Country:US
Mailing Address - Phone:501-954-7845
Mailing Address - Fax:
Practice Address - Street 1:2020 HINSON LOOP RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-3900
Practice Address - Country:US
Practice Address - Phone:501-954-7845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician