Provider Demographics
NPI:1356037642
Name:BUETTNER, RITA AGNES (MSN, RN)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:AGNES
Last Name:BUETTNER
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:AGNES
Other - Last Name:PAOLILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:1436 WINDMOOR DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-4136
Mailing Address - Country:US
Mailing Address - Phone:727-744-8625
Mailing Address - Fax:
Practice Address - Street 1:1436 WINDMOOR DR
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-4136
Practice Address - Country:US
Practice Address - Phone:727-744-8625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9165695163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse