Individual
KELLY BUTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-6494
Mailing address
162 FAIRVIEW AVE APT 7, JERSEY CITY, NJ 07304-1822
(917) 497-0715
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
432288
NY
363LF0000X
Family Nurse Practitioner
342011
NY
Other
Enumeration date
07/27/2017
Last updated
09/10/2024
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