Provider Demographics
NPI:1427591247
Name:BUTLER, BETTY ROBERTSON (DNP, MSN, AGNP-C)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:ROBERTSON
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DNP, MSN, AGNP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16911 MEADOWLEIGH CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3213
Mailing Address - Country:US
Mailing Address - Phone:504-444-5149
Mailing Address - Fax:504-304-9629
Practice Address - Street 1:3157 GENTILLY BLVD # 2374771
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3872
Practice Address - Country:US
Practice Address - Phone:504-444-5149
Practice Address - Fax:504-304-9629
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN164564363LP2300X
LAAP09978363LP2300X, 363LA2200X, 363LG0600X
TXAP133436363LG0600X
TXAPP133436363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95005519OtherNP LICENSE AND FURNISHING NUMBER
LAAP09978OtherLA BON
CO0001306-C-NPOtherCO BON
GA16564OtherGBON
CA95005519OtherCA BON
CA603773OtherRN LICENSE
ARA006113OtherAR BON
TXAP133436OtherTX BON