Provider Demographics
NPI:1417740853
Name:BUTLER, DANELLE LYNN (NP)
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:LYNN
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 1:22925 AIDAN RD
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-5239
Mailing Address - Country:US
Mailing Address - Phone:225-315-4962
Mailing Address - Fax:225-315-4962
Practice Address - Street 1:22925 AIDAN RD
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-5239
Practice Address - Country:US
Practice Address - Phone:225-315-4962
Practice Address - Fax:225-315-4962
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA240676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine