Provider Demographics
NPI:1912633496
Name:BUTLER, REBEKAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 GOODWATER ST
Mailing Address - Street 2:
Mailing Address - City:JENKINS
Mailing Address - State:KY
Mailing Address - Zip Code:41537-9749
Mailing Address - Country:US
Mailing Address - Phone:606-335-9093
Mailing Address - Fax:
Practice Address - Street 1:21 N WEBB ST
Practice Address - Street 2:
Practice Address - City:WHITESBURG
Practice Address - State:KY
Practice Address - Zip Code:41858-7044
Practice Address - Country:US
Practice Address - Phone:606-335-9093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist