Healthcare Provider Details

I. General information

NPI: 1215840582
Provider Name (Legal Business Name): LAURA DALY RN, MN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 RICHLAND AVE
LAFAYETTE LA
70508-6607
US

IV. Provider business mailing address

105 RICHLAND AVE
LAFAYETTE LA
70508-6607
US

V. Phone/Fax

Practice location:
  • Phone: 337-255-5183
  • Fax:
Mailing address:
  • Phone: 337-255-5183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number418837
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: