Healthcare Provider Details

I. General information

NPI: 1083527253
Provider Name (Legal Business Name): LISA DALY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 OAKHILL AVE
WRENTHAM MA
02093-2523
US

IV. Provider business mailing address

167 OAKHILL AVE
WRENTHAM MA
02093-2523
US

V. Phone/Fax

Practice location:
  • Phone: 207-838-3951
  • Fax:
Mailing address:
  • Phone: 207-838-3951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN206203
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: