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1710632625
STACY R BUTLER
FORT WAYNE, IN
NPI
1710632625
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IN 71012324A)
Enumeration Date
2022-02-18
Last Update Date
2023-10-11
Business Address
STACY R BUTLER
3828 NEW VISION DR
FORT WAYNE, IN 46845-1708
Phone number: 260-425-6070
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Mailing Address
STACY R BUTLER
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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