Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 01-05111 | KS |
N | 111N00000X | Chiropractor | 2007008728 | MO |
N | 111N00000X | Chiropractor | 2301009339 | MI |
Y | 111N00000X | Chiropractor | 5602 | OR |
NPI | 1003083973 |
---|---|
Provider Name | Nicole Lynn Butterfield |
First Address | Hood River, OR 97031-2193 |
Second Address | Manzanita, OR 97130-9713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2008 |
Last Update Date | 02/10/2020 |