Provider Demographics
NPI:1194319111
Name:HEESH BUTLER, JESSICA ROBYN (DNP, RN)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ROBYN
Last Name:HEESH BUTLER
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N LANDING DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-5383
Mailing Address - Country:US
Mailing Address - Phone:302-245-3930
Mailing Address - Fax:
Practice Address - Street 1:101 N LANDING DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-5383
Practice Address - Country:US
Practice Address - Phone:302-245-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0038319163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management