Provider Demographics
NPI:1174809743
Name:BUTLER, KIMBERLY ELAINE (RN)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ELAINE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19222 COUNTY ROAD 4108
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-6170
Mailing Address - Country:US
Mailing Address - Phone:903-520-6243
Mailing Address - Fax:903-882-3964
Practice Address - Street 1:19222 COUNTY ROAD 4108
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-6170
Practice Address - Country:US
Practice Address - Phone:903-520-6243
Practice Address - Fax:903-882-3964
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX629358163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health