Healthcare Provider Details

I. General information

NPI: 1427591247
Provider Name (Legal Business Name): BETTY ROBERTSON BUTLER DNP, MSN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3157 GENTILLY BLVD # 2374771
NEW ORLEANS LA
70122-3872
US

IV. Provider business mailing address

16911 MEADOWLEIGH CT
SUGAR LAND TX
77479-3213
US

V. Phone/Fax

Practice location:
  • Phone: 504-444-5149
  • Fax: 504-304-9629
Mailing address:
  • Phone: 504-444-5149
  • Fax: 504-304-9629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP09978
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPP133436
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP133436
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP09978
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN164564
License Number StateGA
# 6
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP09978
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: