Provider Demographics
NPI:1982409280
Name:BUTLER, HOLLY M (RN)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:M
Last Name:BUTLER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 GROVES PARK BLVD E
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7387
Mailing Address - Country:US
Mailing Address - Phone:865-567-1603
Mailing Address - Fax:
Practice Address - Street 1:122 GROVES PARK BLVD E
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7387
Practice Address - Country:US
Practice Address - Phone:865-567-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse