Provider Demographics
NPI:1386961316
Name:BUTTS, JIMMIE K (RN FNP)
Entity type:Individual
Prefix:
First Name:JIMMIE
Middle Name:K
Last Name:BUTTS
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HALPEN DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5667
Mailing Address - Country:US
Mailing Address - Phone:919-380-7551
Mailing Address - Fax:
Practice Address - Street 1:100 HALPEN DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5667
Practice Address - Country:US
Practice Address - Phone:919-380-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0004420363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner