MEDICARE: MS. ANNE M DALY N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	215633-8900	UT

General Provider Information

NPI Number	:	1457452765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE M DALY N.P.

Provider Business Mailing Address
First Line	:	486 5TH AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-3016
Country	:	US
Telephone Number	:	801-364-9751
Fax Number	:

Provider Business Practice Location Address
First Line	:	486 5TH AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-3016
Country	:	US
Telephone Number	:	801-364-9751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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