Individual
REBECCA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1201 INTERNATIONAL DR, COLUMBIA, MO 65202-1612
(572) 615-2001
Mailing address
1903 BRADY DR, JEFFERSON CITY, MO 65101-5595
(573) 230-3308
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024024660
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420145178
—
MO
Enumeration date
06/27/2024
Last updated
02/15/2025
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