Provider Demographics
NPI:1538626213
Name:BUTTARS, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BUTTARS
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 1:6114 4TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2826
Mailing Address - Country:US
Mailing Address - Phone:801-645-3713
Mailing Address - Fax:
Practice Address - Street 1:220 W LEOTA ST STE 2
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6292
Practice Address - Country:US
Practice Address - Phone:308-534-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner