Provider Demographics
NPI:1568260313
Name:BUTLER, TERENA
Entity type:Individual
Prefix:
First Name:TERENA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 N 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-5231
Mailing Address - Country:US
Mailing Address - Phone:402-301-3755
Mailing Address - Fax:
Practice Address - Street 1:7014 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-5231
Practice Address - Country:US
Practice Address - Phone:402-301-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide