Provider Demographics
NPI:1952470502
Name:BUTERA, JOAN MARIE (MSN, FNP, CRNFA)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:BUTERA
Suffix:
Gender:F
Credentials:MSN, FNP, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4843 E HELEN ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4717
Mailing Address - Country:US
Mailing Address - Phone:520-326-7562
Mailing Address - Fax:520-326-7403
Practice Address - Street 1:3817 E SENECA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2926
Practice Address - Country:US
Practice Address - Phone:520-319-8959
Practice Address - Fax:520-795-0150
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ042457163WR0006X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5209556OtherAETNA
AZ2144465OtherUNITED HEALTHCARE
AZ184979OtherAHCCCS
AZAZ028420OtherBCBS
AZ1Z3352OtherHEALTH NET