Healthcare Provider Details

I. General information

NPI: 1952237620
Provider Name (Legal Business Name): PAIGE OLIVIA UTLEY RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 STATE ST
LEXINGTON MO
64067-1107
US

IV. Provider business mailing address

8912 HIGHWAY T
RICHMOND MO
64085-2525
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-7306
  • Fax:
Mailing address:
  • Phone: 660-259-7306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number2020018859
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: