Healthcare Provider Details

I. General information

NPI: 1891547840
Provider Name (Legal Business Name): PAIGE SKYLAR KUTLER MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 IROQUOIS TRL STE 12
ALLENTOWN PA
18104-8644
US

IV. Provider business mailing address

31 LORETTA CIR
RICHBORO PA
18954-1438
US

V. Phone/Fax

Practice location:
  • Phone: 610-395-9595
  • Fax:
Mailing address:
  • Phone: 215-809-9891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN008519
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: