Healthcare Provider Details

I. General information

NPI: 1134015779
Provider Name (Legal Business Name): STEPHEN DAILY FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 SAINT PAUL ST
BALTIMORE MD
21202-2001
US

IV. Provider business mailing address

2807 GARNET RD
BALTIMORE MD
21234-5618
US

V. Phone/Fax

Practice location:
  • Phone: 410-783-5858
  • Fax:
Mailing address:
  • Phone: 443-564-7969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR231186
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: