Provider Demographics
NPI:1831137579
Name:BUTLER, HELEN DENISE (NP)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:DENISE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MORRIS CIR
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-2109
Mailing Address - Country:US
Mailing Address - Phone:318-927-1110
Mailing Address - Fax:318-927-1116
Practice Address - Street 1:104 MORRIS CIR
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040
Practice Address - Country:US
Practice Address - Phone:318-927-1110
Practice Address - Fax:318-927-1116
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO3104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1545520Medicaid