Basic Information
| Provider Information | |||||||||
| NPI: | 1811034093 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUTTS | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3163 S INDIANA ST | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802285498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034325400 | ||||||||
| FaxNumber: | 3034325490 | ||||||||
| Practice Location | |||||||||
| Address1: | 9808 W CEDAR AVE | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802261023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034325400 | ||||||||
| FaxNumber: | 3034325490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 47042 | CO | Y | Nursing Service Providers | Registered Nurse |
No ID Information.