MEDICARE: LISA DALEY

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	183500000X	Pharmacist	10051	TN

General Provider Information

NPI Number	:	1932414737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA DALEY

Provider Business Mailing Address
First Line	:	5244 VILLAGE WAY
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-7328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5244 VILLAGE WAY
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-7328
Country	:	US
Telephone Number	:	901-212-6486
Fax Number	:

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

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	08/17/2010

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Directions to “ LISA DALEY ” Practice Location

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