Provider Demographics
NPI:1851892525
Name:WELKER, STEPHANIE BUTCHER (NP)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:BUTCHER
Last Name:WELKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:BUTCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2828 1ST AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-1236
Mailing Address - Country:US
Mailing Address - Phone:304-525-7111
Mailing Address - Fax:304-525-7112
Practice Address - Street 1:2828 1ST AVE STE 204
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1236
Practice Address - Country:US
Practice Address - Phone:304-525-7111
Practice Address - Fax:304-525-7112
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV87401363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner