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Individual

LESLIE DIANE BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1019 N COUNCIL AVE, SUITE 1, BLANCHARD, OK 73010-8045
(405) 515-0360
(405) 307-5596
Mailing address
PO BOX 1330, NORMAN, OK 73070
(405) 307-6630
(405) 307-6660

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0058298
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100130320A
OK
Enumeration date
03/02/2006
Last updated
06/23/2021
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