Individual
BAILEY NICOLE BUTRUM
Active
Individual
BAILEY NICOLE BUTRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28244094A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71016815A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300116846
—
IN
Enumeration date
06/16/2025
Last updated
11/05/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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