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Individual
ROXANNE M. BUTERAKOS
Active
Individual
ROXANNE M. BUTERAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704185591
MI
363LC0200X
Critical Care Medicine Nurse Practitioner
4704185591
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51149
BLUE SHIELD
MI
01
—
0N84570005
MEDICARE
MI
05
—
3433384
—
MI
Enumeration date
01/11/2006
Last updated
04/01/2024
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