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General NPI Number Information
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NPI Number | 1306147640
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Entity Type | Individual
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Provider Name | STACI LYNN BUTKUS NP
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Gender | Female
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 109 PLAZA DR
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City | SAINT CLAIRSVILLE
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State | OH
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Zip | 43950-7713
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Country | US
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Telephone | 740-695-5200
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Fax | 740-695-8037
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Provider Business Mailing Address
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Address Line | 109 PLAZA DR
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City | SAINT CLAIRSVILLE
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State | OH
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Zip | 43950-9773
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Country | US
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Telephone | 740-695-5200
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Fax | 740-695-8037
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.11975
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License Number State | OH
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