Individual
JOANNA BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 59TH ST N, ST PETERSBURG, FL 33710-8539
(727) 345-2775
Mailing address
4601 11TH AVE N, ST PETERSBURG, FL 33713-5107
(727) 479-7599
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5145900
FL
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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