Provider Demographics
NPI:1740056357
Name:BUTKIEWICZ, MALEVA MARIE (RN)
Entity type:Individual
Prefix:
First Name:MALEVA
Middle Name:MARIE
Last Name:BUTKIEWICZ
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 1:1220 POST RD APT 302
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4246
Mailing Address - Country:US
Mailing Address - Phone:715-412-4306
Mailing Address - Fax:
Practice Address - Street 1:333 E CAMPUS MALL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1365
Practice Address - Country:US
Practice Address - Phone:608-265-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261203163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse