Butler, Shelley Joan
Butler, Shelley Joan is an sole proprietor health care provider with primary practice located at 640 Jackson St , Saint Paul MN 55101-2502. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Butler, Shelley Joan can be contacted via phone (651) 254-4786.Contact Information
Primary practice address
640 Jackson St
Saint Paul MN 55101-2502
Phone: (651) 254-4786
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 13525 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 4144-23 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 4144-23 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 4144-23 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 13525 | Minnesota |
Profile Details
| NPI number | 1619493657 |
|---|---|
| LBN Legal business name | Butler, Shelley Joan |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2017 |
| Last updated | Jan 19th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619493657 | NPPES |
| Wisconsin | MEDICAID | 100147878 |
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