Provider Demographics
NPI:1528327517
Name:BUTT, SHERA ANNETTE (CRNP)
Entity type:Individual
Prefix:
First Name:SHERA
Middle Name:ANNETTE
Last Name:BUTT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SHERA
Other - Middle Name:ANNETTE
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2060 AUTUMN LEAF DR W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-8494
Mailing Address - Country:US
Mailing Address - Phone:251-607-7883
Mailing Address - Fax:
Practice Address - Street 1:2060 AUTUMN LEAF DR W
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-8494
Practice Address - Country:US
Practice Address - Phone:251-607-7883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-068361363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care