Provider Demographics
NPI:1114650348
Name:BUTT, LINDSEY (FNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BUTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 8
Mailing Address - Street 2:
Mailing Address - City:BOISE CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73933-9654
Mailing Address - Country:US
Mailing Address - Phone:806-683-9455
Mailing Address - Fax:
Practice Address - Street 1:100 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:BOISE CITY
Practice Address - State:OK
Practice Address - Zip Code:73933
Practice Address - Country:US
Practice Address - Phone:580-544-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK202039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily