Individual
BROOKE V BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
104 E CULVER RD, 106, KNOX, IN 46534-2241
(574) 772-7400
(574) 772-0299
Mailing address
104 E CULVER RD, 106, KNOX, IN 46534-2241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006066A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193380045
MEDICARE PTAN-B
IN
05
—
201349000
—
IN
Enumeration date
02/09/2016
Last updated
03/08/2021
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