Provider Demographics
NPI:1942470877
Name:BUTLER, KATIE L (CNA/ PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:BUTLER
Suffix:
Gender:F
Credentials:CNA/ PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 WALL ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-5144
Mailing Address - Country:US
Mailing Address - Phone:832-434-7393
Mailing Address - Fax:
Practice Address - Street 1:315 WALL ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-5144
Practice Address - Country:US
Practice Address - Phone:832-434-7393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA513671376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide