1427351766 NPI number — MS. MARY D BUTCHER RPH

Table of content: MS. MARY D BUTCHER RPH (NPI 1427351766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427351766 NPI number — MS. MARY D BUTCHER RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUTCHER
Provider First Name:
MARY
Provider Middle Name:
D
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PUTZER
Provider Other First Name:
MARY
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427351766
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N9417 SAM CREST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PICKETT
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54964-9618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-216-9904
Provider Business Mailing Address Fax Number:
920-589-2135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
N9417 SAM CREST LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PICKETT
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54964-9618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-216-9904
Provider Business Practice Location Address Fax Number:
920-589-2135
Provider Enumeration Date:
12/08/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  11514 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PS 34536 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PH 1849 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 5302361 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 5302030095 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 033.0068159 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 12460-040 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: PU6865 CONSULTANT , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 49611 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 20056196 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PST.019353 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)