Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN2288288 | MA |
NPI | 1013566876 |
---|---|
Provider Name | Meghan Elizabeth Butler |
First Address | Roslindale, MA 02131-1011 |
Second Address | Dedham, MA 02026-4090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2019 |
Last Update Date | 04/01/2021 |