Provider Demographics
NPI:1588927313
Name:BUTLER, MICHELLE MARIE (PSS)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MARIE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04461-3242
Mailing Address - Country:US
Mailing Address - Phone:207-299-2341
Mailing Address - Fax:207-817-3306
Practice Address - Street 1:284 MAIN RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:ME
Practice Address - Zip Code:04461-3242
Practice Address - Country:US
Practice Address - Phone:207-299-2341
Practice Address - Fax:207-817-3306
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide