MRS. MANDY JO BUTLER FNP NPI 1215935549

NPI Information

  • NPI: 1215935549
  • Provider Name: MRS. MANDY JO BUTLER, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 209 ELM ST
    CLOVERPORT, KY
    ZIP 40111
  • Phone: (270) 788-3000

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NPI Details

MRS. Mandy Jo Butler, FNP is a family nurse practitioner in Cloverport, KY with 23 years of experience. MRS. Mandy Jo Butler, FNP NPI is 1215935549. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

209 ELM ST
CLOVERPORT, KY
ZIP 40111-324
Phone: (270) 788-3000
Fax: (270) 788-6201

The NPI 1215935549 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/11/2005 and was last updated on 1/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily4083PKENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000311345OTHERKENTUCKYBCBS
250003764OTHERKENTUCKYPASSPORT
378010758MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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