Provider Demographics
NPI:1033502513
Name:BUTLER, SHELLEY (ARNP, PMHNP)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:ARNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 IMPERIAL GOLF COURSE BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1088
Mailing Address - Country:US
Mailing Address - Phone:239-422-6810
Mailing Address - Fax:833-818-0145
Practice Address - Street 1:975 IMPERIAL GOLF COURSE BLVD STE 113
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1088
Practice Address - Country:US
Practice Address - Phone:239-422-6810
Practice Address - Fax:833-818-0145
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2051372363LF0000X
FLAPRN2051372363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily