Individual
MELISSA R BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5719 WIDEWATERS PKWY, SYRACUSE, NY 13214-1985
(315) 251-3100
(315) 449-9923
Mailing address
5824 WIDEWATERS PKWY, EAST SYRACUSE, NY 13057-3072
(315) 251-3105
(315) 552-6018
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302431
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02694526
—
NY
Enumeration date
05/05/2006
Last updated
07/06/2020
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