Provider Demographics
NPI:1447974514
Name:BUTLER, SARAH ELYSE SANDHEINRICH (RN)
Entity type:Individual
Prefix:
First Name:SARAH ELYSE
Middle Name:SANDHEINRICH
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:620 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-4031
Mailing Address - Country:US
Mailing Address - Phone:618-973-8523
Mailing Address - Fax:
Practice Address - Street 1:6 HAIRPIN DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62026-1000
Practice Address - Country:US
Practice Address - Phone:618-650-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2023-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2015018426163W00000X
KY1179031163W00000X
IL041493204163W00000X
IL209027727367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse