Provider Demographics
NPI:1720524556
Name:BUTLER, CHRISTINE LEE (CPNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LEE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:LEE
Other - Last Name:MCCASLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:4975 LACROSS RD STE 150
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6531
Mailing Address - Country:US
Mailing Address - Phone:843-737-9467
Mailing Address - Fax:
Practice Address - Street 1:2051 CHARLIE HALL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5834
Practice Address - Country:US
Practice Address - Phone:843-573-2535
Practice Address - Fax:843-573-2534
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21073363LP0200X, 363LP0200X
CA95008519363LP0200X
GARN263562363LP0200X, 363LP0222X
TXAP132345363LP0200X, 363LP0222X
AZAP10426363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care