Provider Demographics
NPI:1932092327
Name:BUTLER, ALLISON NICOLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:NICOLE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:MINCO
Mailing Address - State:OK
Mailing Address - Zip Code:73059-0103
Mailing Address - Country:US
Mailing Address - Phone:405-492-6369
Mailing Address - Fax:405-944-3002
Practice Address - Street 1:PO BOX 103
Practice Address - Street 2:
Practice Address - City:MINCO
Practice Address - State:OK
Practice Address - Zip Code:73059-0103
Practice Address - Country:US
Practice Address - Phone:405-492-6369
Practice Address - Fax:405-944-3002
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 246Y00000X
OKL0064518164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information