Individual
COLTON PHILLIP BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6 HAIRPIN DR, EDWARDSVILLE, IL 62026-1000
(618) 650-3956
Mailing address
620 N CHURCH ST, BELLEVILLE, IL 62220-4031
(618) 520-7140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041496067
IL
163W00000X
Registered Nurse
2014009478
IL
163W00000X
Registered Nurse
2014009478
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209027723
IL
Other
Enumeration date
10/03/2022
Last updated
11/19/2023
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