Individual
STEPHANIE ANN BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 LONGWOOD AVE # FEGAN4, BOSTON, MA 02115-5724
(617) 355-6401
Mailing address
NEUROSURGERY DEPT, PROGER 7, BOSTON, MA 02111
(617) 636-5858
(617) 636-7587
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9105719
FL
363A00000X
Physician Assistant
Primary
PA5920
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003510300
—
FL
Enumeration date
11/25/2010
Last updated
12/10/2021
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