STACY R BUTLER

FORT WAYNE, IN
NPI1710632625
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71012324A)
Enumeration Date2022-02-18
Last Update Date2023-10-11
Business Address
STACY R BUTLER
3828 NEW VISION DR
FORT WAYNE, IN 46845-1708
Phone number: 260-425-6070
Mailing Address
STACY R BUTLER
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number: