Healthcare Provider Details

I. General information

NPI: 1831137579
Provider Name (Legal Business Name): HELEN DENISE BUTLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MORRIS CIR
HOMER LA
71040
US

IV. Provider business mailing address

104 MORRIS CIR
HOMER LA
71040-2109
US

V. Phone/Fax

Practice location:
  • Phone: 318-927-1110
  • Fax: 318-927-1116
Mailing address:
  • Phone: 318-927-1110
  • Fax: 318-927-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPO3104
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: