Individual
KELLY ANN BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
179 RIVER ST, ONEONTA, NY 13820-2239
(607) 432-8477
(607) 432-3150
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 729-8156
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F332310
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02848135
—
NY
Enumeration date
08/10/2005
Last updated
01/23/2012
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