Provider Demographics
NPI:1225189756
Name:BUTTS, DONNA LOUISE (NP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LOUISE
Last Name:BUTTS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:22603 ANZA AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3418
Mailing Address - Country:US
Mailing Address - Phone:310-378-0366
Mailing Address - Fax:
Practice Address - Street 1:11525 BROOKSHIRE AVE
Practice Address - Street 2:ATTN MAGGIE NOLES
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4985
Practice Address - Country:US
Practice Address - Phone:562-741-4461
Practice Address - Fax:562-741-4413
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAR.N. 537716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU1106399OtherDRIVERS LICENSE
CA2005010295-22OtherBOARD CERTIFICATION