MEDICARE: KELVOR A DAILEY

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1548895618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELVOR A DAILEY

Provider Business Mailing Address
First Line	:	1221 BRENTWOOD RD NE APT 4
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1019
Country	:	US
Telephone Number	:	202-702-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 BRENTWOOD RD NE APT 4
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1019
Country	:	US
Telephone Number	:	202-702-1300
Fax Number	:

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

Provider Enumeration Date	:	03/09/2020
Last Update Date	:	03/09/2020

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Directions to “ KELVOR A DAILEY ” Practice Location

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