Provider Demographics
NPI:1194411926
Name:BUTLER, KAYLA DAWN (APRN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:DAWN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 ELEANOR DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-0289
Mailing Address - Country:US
Mailing Address - Phone:405-246-8308
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN STE C300J
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2604
Practice Address - Country:US
Practice Address - Phone:405-246-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1112636363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care