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NPI Code Detail

MEDICARE: MARY E DAILEY APRN

MEDICARE: MARY E DAILEY APRN
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
1363LF0000XFamily Nurse Practitioner28574NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110201OTHERNESTATE LICENSE

General Provider Information

NPI Number : 1720012776
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E DAILEY APRN
Provider Business Mailing Address
First Line : 210 MCNEEL LN
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6290
Country : US
Telephone Number : 308-221-6262
Fax Number : 308-221-6261
Provider Business Practice Location Address
First Line : 210 MCNEEL LN
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6290
Country : US
Telephone Number : 308-221-6262
Fax Number : 308-221-6261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 06/28/2016

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Directions to “ MARY E DAILEY APRN” Practice Location

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