| Doctor Name: | STACI LYNN BUTKUS |
| NPI Number: | 1306147640 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 11975 |
| Business Practice Address: | 109 Plaza Dr Saint Clairsville, OH - 439507713 |
| Business Phone Number: | 7406955200 |
| Business Fax Number: | 7406958037 |
| Mailing Address: | 2000 Eoff St, WHEELING |
| State: | WV |
| Postal Code: | 260033823 |
| Phone Number: | 3042348663 |
| Fax Number: | 3042348960 |
| NPI Enumeration Date: | 11/03/2010 |
| NPI Last Update Date: | 05/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 11975 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |