Provider Demographics
NPI:1467974246
Name:BUTLER, MICHELLE L (CRNP, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:BUTLER
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 MARTIN COURT
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 MARTIN CT
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3833
Practice Address - Country:US
Practice Address - Phone:410-820-9823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR126375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily