Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP2051372 | FL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2051372 | FL |
NPI | 1033502513 |
---|---|
Provider Name | Shelley Butler |
First Address | Fort Myers, FL 33912-7139 |
Second Address | Fort Myers, FL 33912-7139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2015 |
Last Update Date | 25/01/2021 |