Individual
JOAN P. BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C, PA-C
Contact information
Practice address
3304 RENNER DR, FORTUNA, CA 95540-7102
(707) 725-4477
(707) 725-9209
Mailing address
670 9TH ST, SUITE 203, ARCATA, CA 95521-6248
(707) 826-8633
(707) 826-8638
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
FNP12891
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN296119
—
CA
Enumeration date
08/08/2006
Last updated
08/22/2014
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