Provider Demographics
NPI:1912630641
Name:BUTTS, CAROLINE WHEELER (PA-S)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:WHEELER
Last Name:BUTTS
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N91W16015 JUNCTION WAY APT 301
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3160
Mailing Address - Country:US
Mailing Address - Phone:910-635-6929
Mailing Address - Fax:
Practice Address - Street 1:2524 E WEBSTER PL STE 301
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4268
Practice Address - Country:US
Practice Address - Phone:414-272-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program