Provider Demographics
NPI:1437401494
Name:BUTLER, COLBY (APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:COLBY
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1458 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2706
Mailing Address - Country:US
Mailing Address - Phone:307-763-4556
Mailing Address - Fax:307-215-8393
Practice Address - Street 1:1458 W 5TH ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2706
Practice Address - Country:US
Practice Address - Phone:307-763-4556
Practice Address - Fax:307-215-8393
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY24970.1206363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner