Individual
MRS. IRALYS ENID BUTTRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,CCRN
Contact information
Practice address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3300
Mailing address
14850 OAK ORCHARD RD, NEW WINDSOR, MD 21776-7718
(443) 844-6711
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
697697
NY
163W00000X
Registered Nurse
Primary
R199271
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
697697
RN LICENSE
NY
01
—
R199271
RN LICENSE
MD
Enumeration date
03/15/2018
Last updated
03/15/2018
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