Individual
MICHELLE UTTLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2727 MCCLELLAND BLVD, JOPLIN, MO 64804-1626
(417) 781-2727
(316) 652-0340
Mailing address
PO BOX 760, JOPLIN, MO 64802-0760
(417) 624-3040
(316) 652-0340
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
115784
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108602A
BCBS
MO
Enumeration date
03/07/2006
Last updated
07/08/2007
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