Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacy R Butler

Individual provider Nurse Practitioner · NPI 1710632625

Stacy R Butler is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2021, 5 years ago. Practices with Parkview Health System Inc, a 1,336-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2022
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Practice location Address checks out

11104 Parkview Circle Dr Ste 10
Fort Wayne, IN 46845-1733
Phone: (260) 425-6070
Fax: (260) 425-6073
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71012324A (IN)

Record details

NPI number1710632625
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 18, 2022
Last updated in NPPESApril 2, 2025
Certification dateApril 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Parkview Health System Inc — 1336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fort Wayne