Individual
KHALIAH JEELAN BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 COLEMAN ST, TALLAHASSEE, FL 32310-6011
(850) 800-6615
Mailing address
1212 COLEMAN ST, TALLAHASSEE, FL 32310-6011
(850) 800-6615
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5237752
FL
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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