Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9219496 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9219496 | FL |
NPI | 1013275635 |
---|---|
Provider Name | Kevin Michael Butenschoen |
First Address | Orlando, FL 32806-1110 |
Second Address | Orlando, FL 32806-1110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 13/11/2014 |