Provider Demographics
NPI:1992708234
Name:BUTZ, ARLENE M (SCD, CRNP)
Entity type:Individual
Prefix:PROF
First Name:ARLENE
Middle Name:M
Last Name:BUTZ
Suffix:
Gender:F
Credentials:SCD, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 BENTLEY RD
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MD
Mailing Address - Zip Code:21053-9517
Mailing Address - Country:US
Mailing Address - Phone:410-614-5963
Mailing Address - Fax:410-502-5440
Practice Address - Street 1:912 BENTLEY RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MD
Practice Address - Zip Code:21053-9517
Practice Address - Country:US
Practice Address - Phone:410-614-5963
Practice Address - Fax:410-502-5440
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR052003363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD25263Medicare ID - Type Unspecified