Individual
MEGAN M BUTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-1626
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 815-1626
(601) 815-1630
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R863308
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09587011
—
MS
05
—
192267
—
AL
Enumeration date
06/26/2012
Last updated
11/14/2016
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