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General NPI Number Information
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NPI Number | 1487225363
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Entity Type | Individual
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Provider Name | BEAU BUTLER NP
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Gender | Male
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 366 BROADWAY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2784
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Country | US
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Telephone | 631-960-5060
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Fax | 347-527-1775
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Provider Business Mailing Address
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Address Line | 366 BROADWAY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2711
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Country | US
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Telephone | 631-960-5060
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Fax | 631-698-7714
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 310774
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 310774
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95183714
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9542421
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 739576
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License Number State | NY
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