Individual
NA KITA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, PMHNP-BC
Contact information
Practice address
700 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-7800
(920) 921-3503
Mailing address
700 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-7800
(920) 921-3503
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
22404130
WI
363L00000X
Nurse Practitioner
12148-033
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12148-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100214225
—
WI
Enumeration date
06/16/2022
Last updated
06/01/2023
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