Provider Demographics
NPI:1689416299
Name:BUTLER, WHITNEY DDD
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:DDD
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHITNEY WALKER
Mailing Address - Street 1:1214 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2735
Mailing Address - Country:US
Mailing Address - Phone:414-837-8558
Mailing Address - Fax:
Practice Address - Street 1:1214 N 45TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-2735
Practice Address - Country:US
Practice Address - Phone:414-837-8558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant