| Doctor Name: | LESLIE DIANE BUTLER |
| NPI Number: | 1790752483 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | R0058298 |
| Business Practice Address: | 1019 N Council Ave Suite 1 Blanchard, OK - 730108045 |
| Business Phone Number: | 4054859321 |
| Business Fax Number: | 4054853154 |
| Mailing Address: | Po Box 1330, NORMAN |
| State: | OK |
| Postal Code: | 73070 |
| Phone Number: | 4053076630 |
| Fax Number: | 4053076660 |
| NPI Enumeration Date: | 03/02/2006 |
| NPI Last Update Date: | 11/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R0058298 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |