Individual
EBONY MICHELLE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 2ND ST NW APT 70, WINTER HAVEN, FL 33881-4942
(407) 319-8694
Mailing address
2401 2ND ST NW APT 70, WINTER HAVEN, FL 33881-4942
(407) 319-8694
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5224604
FL
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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