Healthcare Provider Details

I. General information

NPI: 1215064688
Provider Name (Legal Business Name): ASHLEY DAILY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N 4TH ST
MONROE LA
71201-5909
US

IV. Provider business mailing address

18 COLE RD
OAK RIDGE LA
71264-4001
US

V. Phone/Fax

Practice location:
  • Phone: 318-387-7817
  • Fax: 318-322-0914
Mailing address:
  • Phone: 318-728-2909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN096639
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: