Provider Demographics
NPI:1316248933
Name:PAIGE, KELLEY LYNN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:LYNN
Last Name:PAIGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:KELLEY
Other - Middle Name:PAIGE
Other - Last Name:BUTERBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4720 FIREBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1482
Mailing Address - Country:US
Mailing Address - Phone:615-364-5829
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 435
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:615-292-1321
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16174367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered