Provider Demographics
NPI:1528426483
Name:BUTTON, RANDALYN (CNP)
Entity type:Individual
Prefix:
First Name:RANDALYN
Middle Name:
Last Name:BUTTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3328
Mailing Address - Country:US
Mailing Address - Phone:580-323-2300
Mailing Address - Fax:580-323-8710
Practice Address - Street 1:700 SUGAR CREEK DR.
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:OK
Practice Address - Zip Code:73047-1018
Practice Address - Country:US
Practice Address - Phone:405-542-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK89144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily