Provider Demographics
NPI:1942726708
Name:BUTTELING, SHARILYN
Entity Type:Individual
Prefix:
First Name:SHARILYN
Middle Name:
Last Name:BUTTELING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ULI PL
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-9358
Mailing Address - Country:US
Mailing Address - Phone:808-281-5330
Mailing Address - Fax:
Practice Address - Street 1:270 HOOKAHI ST STE 207
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1466
Practice Address - Country:US
Practice Address - Phone:808-242-1660
Practice Address - Fax:808-242-6650
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2303363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health