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Contact Information

MALLORY A BUTLER, FNP
325 SPRING ST
RED BUN, IL62278
 Phone: 618-282-3831
 Fax: 618-282-5476
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MALLORY A BUTLER · (Female)

NPI Number 1467803049
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 06/24/2016
Last updated 06/29/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 209014336
  • MO License # 2016018336
Hospital affiliation(s)
  • RED BUD REGIONAL HOSPITAL - (Critical Access)
    325 SPRING STREET
    RED BUD, IL 62278
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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