Individual
MRS. CINDY SUE BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2002 BROOKSIDE DR, SUITE102, KINGSPORT, TN 37660-4634
(423) 245-6000
(423) 245-6062
Mailing address
2002 BROOKSIDE DR, SUITE102, KINGSPORT, TN 37660-4634
(423) 245-6000
(423) 245-6062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
90068RN
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3706367
—
TN
01
—
4081210
BLUE CROSS BLUE SHIELD
TN
01
—
TN0107
JOHN DEERE
TN
Enumeration date
10/31/2005
Last updated
01/28/2020
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