Individual
MRS. MALLORY ANN BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
325 SPRING ST, RED BUN, IL 62278
(618) 282-3831
(618) 282-5476
Mailing address
325 SPRING ST, RED BUN, IL 62278
(618) 282-3831
(618) 282-5476
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2016018336
MO
363LF0000X
Family Nurse Practitioner
Primary
209014336
IL
Other
Enumeration date
06/24/2016
Last updated
06/29/2021
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