Healthcare Provider Details

I. General information

NPI: 1922486653
Provider Name (Legal Business Name): MEGAN DALY DAVIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN ALYSSA DALY CRNP

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5356 STADIUM TRACE PKWY SUITE 200
HOOVER AL
35244-5607
US

IV. Provider business mailing address

5356 STADIUM TRACE PKWY SUITE 200
HOOVER AL
35244-5607
US

V. Phone/Fax

Practice location:
  • Phone: 205-985-9424
  • Fax: 205-985-9465
Mailing address:
  • Phone: 205-985-9424
  • Fax: 205-985-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-137131
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-137131
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: