Provider Demographics
NPI:1164222550
Name:BUTNER, JOLENE
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:
Last Name:BUTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 C AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-3046
Mailing Address - Country:US
Mailing Address - Phone:308-240-1163
Mailing Address - Fax:
Practice Address - Street 1:2059 Q RD
Practice Address - Street 2:
Practice Address - City:HEARTWELL
Practice Address - State:NE
Practice Address - Zip Code:68945-2046
Practice Address - Country:US
Practice Address - Phone:308-240-1163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE39629373104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker