Butler, Jesse Van

Butler, Jesse Van is an individual health care provider with primary practice located at 901 Montgomery St , Decorah IA 52101-2325. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Butler, Jesse Van can be contacted via phone (563) 382-2911.

Contact Information

Primary practice address
901 Montgomery St Decorah IA 52101-2325
Phone: (563) 382-2911
Fax: (563) 387-1512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 10116 Minnesota

Profile Details

NPI number 1376557769
LBN Legal business name Butler, Jesse Van
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Mar 8th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376557769 NPPES
Iowa Other 001606 LICENSE
Iowa Other 10116 LICENSE
Iowa MEDICAID 0446294 LICENSE

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