Provider Demographics
NPI:1598461667
Name:BUTTERBAUGH, LENORA (APRN)
Entity Type:Individual
Prefix:DR
First Name:LENORA
Middle Name:
Last Name:BUTTERBAUGH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 19TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-2505
Mailing Address - Country:US
Mailing Address - Phone:386-218-5854
Mailing Address - Fax:
Practice Address - Street 1:365 WEKIVA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3684
Practice Address - Country:US
Practice Address - Phone:407-821-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024008363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care