Individual
TRACEY M. BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8401 MARKET ST, YOUNGSTOWN, OH 44512
(330) 729-2929
Mailing address
4135 BOARDMAN CANFIELD RD STE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1103844
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
RN.395377
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000838469
ANTHEM BCBS
OH
05
—
2643812
—
OH
01
—
H190010
MEDICARE PTAN
OH
01
—
P01356545
MEDICARE RAILROAD
OH
Enumeration date
04/09/2006
Last updated
04/25/2023
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