IndividualActive
Emily Buttkus, PAC
NPI 1417646464 · Surgical Physician Assistant · Lebanon, TN
Provider details
- NPI number
- 1417646464
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Female
- Sole proprietor
- Yes
- License
- PA0000005515 (TN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
100 Physicians Way Ste 110
Lebanon, TN 37090-8107
Phone: (615) 547-6700
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 370
Fortson, GA 31808-0370
Registry dates
- Enumerated
- 2023-05-04
- Last updated
- 2023-09-08
- Certified
- 2023-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.