Basic Information
| Provider Information | |||||||||
| NPI: | 1699322859 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 CHURCH HILL RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | LEEDS | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042633418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075243501 | ||||||||
| FaxNumber: | 2079339645 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 ACADEMY RD | ||||||||
| Address2: | |||||||||
| City: | MONMOUTH | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042597035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075243501 | ||||||||
| FaxNumber: | 2079339645 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2019 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | CNP191109 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.