Provider Demographics
NPI:1316496318
Name:BUTLER, SCOTT M (FNP-C)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:M
Last Name:BUTLER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 FIELDBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:DE
Mailing Address - Zip Code:19962-1481
Mailing Address - Country:US
Mailing Address - Phone:302-724-9294
Mailing Address - Fax:
Practice Address - Street 1:431 FIELDBROOK DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:DE
Practice Address - Zip Code:19962-1481
Practice Address - Country:US
Practice Address - Phone:302-724-9294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily